Active NPI
C Emory Johnson Jr., MD
- Orthopaedic Surgery of the Spine Physician
- Macon, GA
National Provider Identifier
1689743965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery of the Spine Physician
- License
- 01196511
- Practice address
- 3708 Northside Dr
Macon, GA 31210-2404 - Phone
- (478) 745-4206
- Fax
- (478) 254-5463
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery of the Spine Physician | 207XS0117X | 01196511 | GA | Primary |
Addresses
Primary practice location
3708 Northside Dr
Macon, GA 31210-2404
Mailing address
PO Box 6317
Macon, GA 31208
Phone (478) 745-4206
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200018430 | Other | GA | MEDICARE RAILROAD |
| 00077239A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01196511 | GA | MD | Orthopaedic Surgery of the Spine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthogeorgia Rehab Services | Past | Accepting new patients | |
| Macon Orthopaedic & Hand Center, PA | Orthopaedic Surgery of the Spine | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba OrthoGeorgia
- Orthopaedic Surgery Physician
- Macon, GA
- NPI 1356489850
Orthopaedic Surgery of the Spine
-
- Rehabilitation Clinic/Center
- Macon, GA
- NPI 1972030070
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306886400000",
"number": "1689743965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6317",
"city": "MACON",
"state": "GA",
"postal_code": "31208",
"telephone_number": "478-745-4206",
"fax_number": "478-254-5463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3708 NORTHSIDE DR",
"city": "MACON",
"state": "GA",
"postal_code": "312102404",
"telephone_number": "478-745-4206",
"fax_number": "478-254-5463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "C",
"middle_name": "EMORY",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2011-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0117X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
"state": "GA",
"license": "01196511",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "200018430",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00077239A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.