NPIMap

Individual provider Active NPI

Jeffrey Neal Johnson, M.D.

  • Internal Medicine Physician
  • Columbia, MS
National Provider Identifier
1689698318
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
15313 Issued in MS
Practice address
914 Sumrall Rd
Columbia, MS 39429-2652
Phone
(601) 731-1470
Fax
(601) 731-1474
NPI assigned
Jul 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 15313 MS Primary

Addresses

Primary practice location

914 Sumrall Rd
Columbia, MS 39429-2652

Mailing address

914 Sumrall Rd
Columbia, MS 39429-2652
Phone (601) 731-1470

Other identifiers 1

IdentifierTypeStateIssuer
00118179MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090819000824 MS Practitioner - Internal MedicinePractitioner - General PracticePractitioner - Emergency Medicine 3870647266 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
University of Mississippi School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forrest County General HospitalGroup PAC ID 1052397767, 107 clinicians
Internal Medicine Clinic of Columbia, P.a.Group PAC ID 6507982410, 3 clinicians

Practice addresses (Care Compare)

1560 Sumrall Rd
Columbia, MS 39429-2654
Phone (601) 736-6303

914 Sumrall Rd
Columbia, MS 39429-2652
Phone (601) 731-1470

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Forrest County General Hospital CurrentSince Feb 26, 2012 Accepting new patients
Forrest County General Hospital CurrentSince Feb 26, 2012 Accepting new patients
Keystone Medical Services of Ms, Inc CurrentSince Jan 5, 2012 Accepting new patients
Internal Medicine Clinic of Columbia, P.a. CurrentSince Jul 8, 1997 Accepting new patients
Forrest County General Hospital Current Accepting new patients
RH Emergency Medicine of Marion General LLC CurrentSince Jan 1, 2024 Accepting new patients
Marion General Hospital Past Accepting new patients

Locations

1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303

910 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-0177

914 Sumrall Rd
Columbia, MS 39429
Phone (601) 731-1470

100 Hospital Dr
Tylertown, MS 39667
Phone (601) 876-0455

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Internal Medicine Clinic of Columbia, P.a.Columbia, MS, CCN 258902 Rural health clinic 5% Or Greater Direct Ownership Interest
Corporate Officer
Corporate Director
W-2 Managing Employee		 Sep 26, 2011
Sep 26, 2011
Sep 26, 2011
Sep 26, 2011

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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

Hospital & facility affiliations 9

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689698318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 SUMRALL RD",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394292652",
            "telephone_number": "601-731-1470",
            "fax_number": "601-731-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 SUMRALL RD",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394292652",
            "telephone_number": "601-731-1470",
            "fax_number": "601-731-1474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEFFREY",
        "middle_name": "NEAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "15313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00118179",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MS

Sources for this page

Verify at the official NPI Registry.