Individual provider Active NPI

Richard S. Johnson, DO

  • Surgical Critical Care Physician
  • Memphis, TN
National Provider Identifier
1740691765
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
34014608 Issued in OH
Practice address
880 Madison Ave
Memphis, TN 38103-3409
Phone
(901) 545-7222
Fax
(901) 545-8292
NPI assigned
May 13, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 34014608 OH
Surgical Critical Care Physician 2086S0102X 34014608 OH Primary

Addresses

Primary practice location

880 Madison Ave
Memphis, TN 38103-3409

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-2101

Other practice location 1

1581 Dodd Dr
Columbus, OH 43210-1257
Phone (614) 293-2101

Other identifiers 1

IdentifierTypeStateIssuer
0409720MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20231013002738 TN Practitioner - General Surgery 1355688391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Regional One Physicians IncGroup PAC ID 5698993418, 314 clinicians

Practice addresses (Care Compare)

880 Madison Ave
Memphis, TN 38103-3409
Phone (901) 545-6969

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.97 of 100Reported as group
Quality
64.58
Improvement activities
40
Cost
77.33

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Regional One Physicians Inc CurrentSince Sep 6, 2023 Accepting new patients
Ut Regional One Physicians Inc Surgery CurrentSince Sep 6, 2023 Accepting new patients

Locations

6215 Humphreys Blvd
Ste 201
Memphis, TN 38120
Phone (901) 866-8085

880 Madison Ave
Memphis, TN 38103
Phone (901) 515-3500

877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1740691765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-2101",
            "fax_number": "614-293-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033409",
            "telephone_number": "901-545-7222",
            "fax_number": "901-545-8292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1581 Dodd Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101257",
            "country_code": "US",
            "telephone_number": "614-293-2101",
            "fax_number": "614-293-9155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RICHARD",
        "middle_name": "S.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-13",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "34014608",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "OH",
            "license": "34014608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0409720",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.