Patrick Todd Johnson, D.M.D., P.A.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN13415 Issued in FL

Practice address

5111 Ehrlich Rd
Suite150
Tampa, FL 33624-2075

Phone

(813) 264-1258

Fax

(813) 265-2083

NPI assigned

Jan 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710033774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 EHRLICH RD",
            "address_2": "SUITE150",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336242075",
            "telephone_number": "813-264-1258",
            "fax_number": "813-265-2083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 EHRLICH RD",
            "address_2": "SUITE150",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336242075",
            "telephone_number": "813-264-1258",
            "fax_number": "813-265-2083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PATRICK",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "D.M.D., P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN13415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "DN13415",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nahima Johnson, DPT
• Natasha Johnson, ARNP
• Nathan Ray Johnson, LMT
• Nehelia Cedella Johnson, ARNP
• Patrick Jonas Johnson, ARNP, FNP-C
• Phekila D Johnson, MS, LMHC
• Philip Nathaniel Johnson, M.D.
• Rachel Nicole Johnson, MSW
• Ramey Rene Johnson
• Reginald Antwan Johnson

• Periodontics in Tampa, FL
• Providers in Tampa, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.