NPIMap

Individual provider Active NPI

Coy H Johnston III, MD

  • Family Medicine Physician
  • Weston, WI
National Provider Identifier
1720371321
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
59857 Issued in WI
Practice address
4005 Community Center Dr
Weston, WI 54476-4139
Phone
(715) 241-5400
NPI assigned
May 16, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 59857 WI Primary

Addresses

Primary practice location

4005 Community Center Dr
Weston, WI 54476-4139

Mailing address

4005 Community Center Dr
Weston, WI 54476-4139
Phone (715) 241-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, AZ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130321000458 WI Practitioner - Family PracticePractitioner - Emergency Medicine 9537112545 Reassigns benefits to 4 organizations
I20191014001532 AZ Practitioner - Family Practice 9537112545 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innova Emergency Medical Associates PCGroup PAC ID 2860633435, 69 clinicians

Practice addresses (Care Compare)

2200 E Show Low Lake Rd
Show Low, AZ 85901-7831
Phone (928) 537-4375

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59857WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Healthcare LLC CurrentSince Sep 1, 2019 Accepting new patients
Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin CurrentSince Jun 19, 2015 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Oct 5, 2015 Accepting new patients
Aspirus Wausau Hospital Inc CurrentSince Jul 22, 2014 Accepting new patients
Reedsburg Area Medical Center, Inc. Current Accepting new patients
Aspirus Wausau Hospital, Inc. Current Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Oct 5, 2015 Accepting new patients
Reedsburg Area Medical Center Inc CurrentSince Jul 13, 2013 Accepting new patients
Aspirus Medical Group, Inc. Current Accepting new patients
Langlade Hospital - Hotel Dieu of St Joseph of Antigo Wisconsin Family Medicine Current Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Jun 19, 2015 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Jul 22, 2014 Accepting new patients
Innova Emergency Medical Associates PC CurrentSince Oct 1, 2024 Accepting new patients
Reedsburg Area Medical Center, Inc. Family Medicine CurrentSince Jul 13, 2013 Accepting new patients
Summit Healthcare Association Past Accepting new patients

Locations

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

29980 Network Pl
Chicago, IL 60673

112 E 5th Ave
Antigo, WI 54409
Phone (715) 623-2331

135 S Gibson St
Medford, WI 54451
Phone (715) 748-8100

2000 N Dewey Ave
Reedsburg, WI 53959
Phone (608) 524-6487

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

410 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-5257

1660 Sue Alan Dr
Wittenberg, WI 54499
Phone (715) 253-2110

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1720371321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 COMMUNITY CENTER DR",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544764139",
            "telephone_number": "715-241-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 COMMUNITY CENTER DR",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544764139",
            "telephone_number": "715-241-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "COY",
        "middle_name": "H",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-16",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "59857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, WI

Sources for this page

Verify at the official NPI Registry.