Individual provider Active NPI

John Alexander Johnson, M.D.

  • Hospitalist Physician
  • Seneca, SC
National Provider Identifier
1699764555
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
38746 Issued in SC
Practice address
298 Memorial Dr
Seneca, SC 29672-9443
Phone
(864) 885-7758
Fax
(864) 885-7749
NPI assigned
Oct 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 046866 GA
Hospitalist Physician 208M00000X 38746 SC Primary

Addresses

Primary practice location

298 Memorial Dr
Seneca, SC 29672-9443

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

6128 Prestley Mill Rd
Suite G
Douglasville, GA 30134-5621
Phone (770) 942-6903

Other identifiers 2

IdentifierTypeStateIssuer
387469MedicaidSC
00876697BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL, SC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20110418000072 GA Practitioner - Internal MedicinePractitioner - Emergency Medicine 5294919296 Reassigns benefits to 1 organization
I20160229002611 AL Practitioner - Internal Medicine 5294919296 Reassigns benefits to 1 organization
I20191018001550 SC Practitioner - Internal MedicinePractitioner - Family Practice 5294919296 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians Internal Medicine CurrentSince Jan 30, 2022 Accepting new patients
Carolina Family Care, Inc CurrentSince May 4, 2021 Accepting new patients
Prisma Health University Medical Group Internal Medicine CurrentSince Aug 28, 2022 Accepting new patients
Musc Community Physicians CurrentSince Jan 30, 2022 Accepting new patients
Emergency Group of Columbus, LLC CurrentSince Mar 1, 2018 Accepting new patients
Houston County Healthcare Authority Internal Medicine Current Accepting new patients
Carolina Family Care, Inc Internal Medicine CurrentSince May 4, 2021 Accepting new patients
Prisma Health University Medical Group CurrentSince Aug 28, 2022 Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

805 Pamplico Hwy
Florence, SC 29505
Phone (843) 674-2500

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

1341 Old Georgetown Rd
Ste C
Mt Pleasant, SC 29464
Phone (843) 884-2175

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1699764555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 MEMORIAL DR",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296729443",
            "telephone_number": "864-885-7758",
            "fax_number": "864-885-7749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6128 Prestley Mill Rd",
            "address_2": "SUITE G",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301345621",
            "country_code": "US",
            "telephone_number": "770-942-6903",
            "fax_number": "770-942-6908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOHN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "046866",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "38746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387469",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00876697B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

Verify at the official NPI Registry.