Individual provider Active NPI

Lance Johnson, MD

  • Sports Medicine (Family Medicine) Physician
  • Burleson, TX
National Provider Identifier
1740676907
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
R9631 Issued in TX
Practice address
215 Old Highway 1187
Burleson, TX 76028-0281
Phone
(817) 926-2663
Fax
(817) 293-8860
NPI assigned
Apr 14, 2015
Last updated
Sep 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A161921 CA
Family Medicine Physician 207Q00000X R9631 TX
Sports Medicine (Family Medicine) Physician 207QS0010X A161921 CA
Sports Medicine (Family Medicine) Physician 207QS0010X R9631 TX Primary

Addresses

Primary practice location

215 Old Highway 1187
Burleson, TX 76028-0281

Mailing address

215 Old Highway 1187
Burleson, TX 76028-0281
Phone (817) 926-2663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240905003159 TX Practitioner - Sports MedicinePractitioner - Family Practice 7315279676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Loma Linda University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lone Star Orthopaedic and Spine Specialists, PLLCGroup PAC ID 5597844951, 19 clinicians

Practice addresses (Care Compare)

215 Old Hwy 1187
Burleson, TX 76028-0281
Phone (817) 926-2663

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A161921CAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lone Star Orthopaedic and Spine Specialists, PLLC CurrentSince Jul 29, 2024 Accepting new patients
Scripps Health Current Accepting new patients
Lone Star Orthopaedic and Spine Specialists, PLLC CurrentSince Jul 29, 2024 Accepting new patients
Major Hospital Past Accepting new patients

Locations

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

215 Old Highway 1187
Burleson, TX 76028
Phone 8179262663118

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

167 Regency Pkwy
Ste 103
Mansfield, TX 76063
Phone (682) 341-7110

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EABGAA
  • Direct secure messaging: ljohnson317934@scrippshlth.medalliesdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1740676907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 OLD HIGHWAY 1187",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760280281",
            "telephone_number": "817-926-2663",
            "fax_number": "817-293-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 OLD HIGHWAY 1187",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760280281",
            "telephone_number": "817-926-2663",
            "fax_number": "817-293-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LANCE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-14",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A161921",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R9631",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "A161921",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "R9631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

Verify at the official NPI Registry.