Individual provider Active NPI

Thomas Brian Johnson, MD

  • Emergency Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1679510291
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME78286 Issued in FL
Practice address
13681 Doctors Way
Fort Myers, FL 33912-4300
Phone
(239) 343-3292
Fax
(239) 343-3695
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME78286 FL Primary

Addresses

Primary practice location

13681 Doctors Way
Fort Myers, FL 33912-4300

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-3292

Other practice location 1

2776 Cleveland Ave
Fort Myers, FL 33901-5864
Phone (239) 343-3292

Other identifiers 1

IdentifierTypeStateIssuer
258865000MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tjohnson22782@Direct.leememorial.org Direct Lee Memorial Health System

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061219000150 FL Practitioner - Emergency Medicine 0749289809 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

13681 Doctors Way
Fort Myers, FL 33912-4300
Phone (239) 343-2606

Hospital & facility affiliations

  • Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220
  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME78286FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System Current Accepting new patients
Lee Memorial Health System CurrentSince Jun 5, 2022 Accepting new patients
Southwest Florida Emergency Physicians, PA Emergency Medicine CurrentSince Jul 15, 2000 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Jun 5, 2022 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344

23450 Via Coconut Pt
Estero, FL 34135
Phone (239) 468-0150

10201 Arcos Ave
Ste 105
Estero, FL 33928
Phone (239) 333-2273

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 332-5344

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: tjohnson22782@direct.leememorial.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1679510291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-3292",
            "fax_number": "239-343-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13681 DOCTORS WAY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124300",
            "telephone_number": "239-343-3292",
            "fax_number": "239-343-3695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2776 Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339015864",
            "country_code": "US",
            "telephone_number": "239-343-3292",
            "fax_number": "239-343-3695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "THOMAS",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME78286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258865000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tjohnson22782@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.