Norman Richard Johnson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

36-059258 Issued in IL

Practice address

4625 N. University St.
Peoria, IL 61614

Phone

(309) 648-3056

Fax

(309) 692-8106

NPI assigned

Aug 22, 2006

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730295692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10010",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616120010",
            "telephone_number": "309-692-8100",
            "fax_number": "309-692-8106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 N. UNIVERSITY ST.",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-648-3056",
            "fax_number": "309-692-8106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NORMAN",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36-059258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "0007232070",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Kay Johnson, NP-C
• Michael Johnson, MD
• Michelle D Johnson, APN
• Michelle Elise Johnson, MT
• Moriah Johnson, APRN-FNP-C
• Ryan Anthony Johnson
• Simeon Shirell Johnson, APRN
• Socorro Johnson
• Stephany Johnson, RD
• Barbara L Johnston, NP APN RN MS

• Internal Medicine Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Internal Medicine Physician in Illinois

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.