Active NPI
Doyle Richard Johnson, M.D.
- Specialist
- Little Rock, AR
National Provider Identifier
1710967278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- C4546
- Practice address
- 500 S University Ave
Suite 318
Little Rock, AR 72205-5302 - Phone
- (501) 664-8000
- Fax
- (501) 664-5014
- NPI assigned
- Jan 20, 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 |
|---|---|---|---|---|
| Specialist | 174400000X | C4546 | AR | Primary |
Addresses
Primary practice location
500 S University Ave
Suite 318
Little Rock, AR 72205-5302
Mailing address
500 S University Ave
Suite 318
Little Rock, AR 72205-5302
Phone (501) 664-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104706001 | Medicaid | AR |
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 |
|---|---|---|---|
| C4546 | AR | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442188800000",
"number": "1710967278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 S UNIVERSITY AVE",
"address_2": "SUITE 318",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722055302",
"telephone_number": "501-664-8000",
"fax_number": "501-664-5014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 S UNIVERSITY AVE",
"address_2": "SUITE 318",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722055302",
"telephone_number": "501-664-8000",
"fax_number": "501-664-5014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "DOYLE",
"middle_name": "RICHARD",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-20",
"last_updated": "2015-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "AR",
"license": "C4546",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104706001",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.