NPIMap

Individual provider Active NPI

Charles Johnson II, M D

  • Diagnostic Radiology Physician
  • Hollywood, FL
National Provider Identifier
1750592978
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME 61312 Issued in FL
Practice address
4601 Washington St
Hollywood, FL 33021-7647
Phone
(954) 424-1873
Fax
(954) 200-7814
NPI assigned
May 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME 61312 FL Primary

Addresses

Primary practice location

4601 Washington St
Hollywood, FL 33021-7647

Mailing address

4601 Washington St
Hollywood, FL 33021-7647
Phone (954) 424-1873

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160429000957 TX Practitioner - Diagnostic Radiology 6406832716 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 61312FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ton Sells Hospital CurrentSince Mar 26, 2016 Accepting new patients
Comprehensive Diagnostics Inc. CurrentSince Apr 1, 2023 Accepting new patients
Ton San Xavier Health Center CurrentSince Mar 26, 2016 Accepting new patients
Sonocare Diagnostic Imaging Inc CurrentSince Aug 1, 2017 Accepting new patients
Ton San Simon Health Center CurrentSince Mar 26, 2016 Accepting new patients
Radiology Medical Group Inc Diagnostic Radiology PastSince May 11, 2025 Accepting new patients
Ton Sells Hospital Past Accepting new patients
Ton San Xavier Health Center Past Accepting new patients
Mercy Medical Development Inc Diagnostic Radiology Past Accepting new patients
South Florida Medical Imaging, PA Diagnostic Radiology PastSince Aug 8, 2021 Accepting new patients

Locations

7900 S J Stock Rd
Tucson, AZ 85746
Phone (520) 295-2550

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1180310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1750592978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 WASHINGTON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330217647",
            "telephone_number": "954-424-1873",
            "fax_number": "954-200-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 WASHINGTON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330217647",
            "telephone_number": "954-424-1873",
            "fax_number": "954-200-7814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHARLES",
        "name_suffix": "II",
        "credential": "M D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-28",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME 61312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.