Active NPI
Gregory Johnson, M.D.
- Pediatric Anesthesiology Physician
- Philadelphia, PA
National Provider Identifier
1699068049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Anesthesiology Physician
- License
- MD455466
- Practice address
- 3401 Civic Center Blvd
Philadelphia, PA 19104-4319 - Phone
- (215) 590-1858
- Fax
- (215) 590-1415
- NPI assigned
- May 18, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD455466 | PA | |
| Pediatric Anesthesiology Physician | 207LP3000X | MD455466 | PA | Primary |
Addresses
Primary practice location
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Mailing address
1726 Pine St
Apt 2R
Philadelphia, PA 19103-6780
Phone (248) 767-3734
Other practice location 1
550 S Goddard Blvd
King Of Prussia, PA 19406-2922
Phone (610) 337-3232
Other practice location 2
525 E 68th St
New York, NY 10065-4870
Phone (212) 746-2962
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 |
|---|---|---|---|
| MD455466 | PA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685491200000",
"number": "1699068049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1726 PINE ST",
"address_2": "APT 2R",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191036780",
"telephone_number": "248-767-3734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044319",
"telephone_number": "215-590-1858",
"fax_number": "215-590-1415"
}
],
"practiceLocations": [
{
"address_1": "550 S Goddard Blvd",
"address_purpose": "LOCATION",
"city": "King Of Prussia",
"state": "PA",
"postal_code": "194062922",
"country_code": "US",
"telephone_number": "610-337-3232",
"fax_number": "610-337-0325",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "525 E 68th St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100654870",
"country_code": "US",
"telephone_number": "212-746-2962",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "GREGORY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-18",
"last_updated": "2023-05-31",
"certification_date": "2023-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "PA",
"license": "MD455466",
"primary": false
},
{
"code": "207LP3000X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pediatric Anesthesiology",
"state": "PA",
"license": "MD455466",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.