Individual provider Active NPI

Jeffrey Thomas Johnston, MD

  • Vascular Surgery Physician
  • Memphis, TN
National Provider Identifier
1679969729
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
0000000000 Issued in TN
Practice address
910 Madison Ave FL 2
Memphis, TN 38103-3403
Phone
(901) 448-5914
Fax
(901) 448-7306
NPI assigned
Apr 15, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 0000000000 TN Primary

Addresses

Primary practice location

910 Madison Ave FL 2
Memphis, TN 38103-3403

Mailing address

910 Madison Ave FL 2
Memphis, TN 38103-3403
Phone (901) 448-5914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20220921003808 SC Practitioner - Vascular Surgery 2860877172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Medical University of South Carolina College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Saint Francis Dr
Greenville, SC 29601-3955
Phone (513) 853-8520

125 Commonwealth Dr
Greenville, SC 29615-4812
Phone (864) 675-4000

317 Saint Francis Dr
Greenville, SC 29601-3914

317 Saint Francis Dr
Suite 220
Greenville, SC 29601-3976
Phone (864) 255-1901

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Leg revascularization (restoring blood flow)22
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000000000TNMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince Aug 28, 2022 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince Aug 28, 2022 Accepting new patients
St Francis Hospital Inc Past Accepting new patients

Locations

317 Saint Francis Dr
Ste 340
Greenville, SC 29601
Phone (864) 255-1834

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

Interoperability endpoints

  • Direct secure messaging: jjohnston1343426@direct.bsmhealth.org

Organizations & group practices 3

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 6

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": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1679969729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 MADISON AVE FL 2",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033403",
            "telephone_number": "901-448-5914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 MADISON AVE FL 2",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033403",
            "telephone_number": "901-448-5914",
            "fax_number": "901-448-7306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "JEFFREY",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-15",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TN",
            "license": "0000000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.