NPIMap

Individual provider Active NPI

Victoria S Johnson, MD

  • Family Medicine Physician
  • Venice, FL
National Provider Identifier
1760595904
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME153040 Issued in FL
Practice address
395 Commercial CT Ste a
Venice, FL 34292-1651
Phone
(941) 261-0010
Fax
(941) 261-0011
NPI assigned
Aug 15, 2006
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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 ME153040 FL Primary

Addresses

Primary practice location

395 Commercial CT Ste a
Venice, FL 34292-1651

Mailing address

PO Box 947407
Atlanta, GA 30394-7407
Phone (941) 917-2600

Other practice location 1

435 Commercial Ct Unit 300
Venice, FL 34292-1667
Phone (941) 261-0010

Other identifiers 2

IdentifierTypeStateIssuer
111994400MedicaidFL
OF711OtherFLFL MC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20211007000147 FL Practitioner - Family Practice 1153445127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rush Medical College of Rush University, 1997
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Nokomis Physical Therapy LLCGroup PAC ID 8628240843, 104 clinicians
Empath Therapies LLCGroup PAC ID 5496144529, 108 clinicians
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

109 Laurel Rd E
Nokomis, FL 34275-5233
Phone (941) 375-8734

3600 William Penn Way
Venice, FL 34293-5236
Phone (941) 483-0746

435 Commercial CT
Unit 300
Venice, FL 34292-1667
Phone (941) 917-8720

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME153040FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc Family Medicine CurrentSince Nov 29, 2021 Accepting new patients
SMH Physician Services Inc Past Accepting new patients

Locations

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

395 Commercial Ct
Ste A
Venice, FL 34292
Phone (941) 261-0010

435 Commercial Ct
Unit 300
Venice, FL 34292
Phone (941) 261-0010

Interoperability endpoints

  • Direct secure messaging: victoria.johnson@fpg.directbygreenway.com

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 7

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1760595904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 COMMERCIAL CT STE A",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342921651",
            "telephone_number": "941-261-0010",
            "fax_number": "941-261-0011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 Commercial Ct Unit 300",
            "address_purpose": "LOCATION",
            "city": "Venice",
            "state": "FL",
            "postal_code": "342921667",
            "country_code": "US",
            "telephone_number": "941-261-0010",
            "fax_number": "941-261-0011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VICTORIA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME153040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111994400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MC",
            "identifier": "OF711",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

Verify at the official NPI Registry.