Sean Matthew Johnson, DO
Individual provider Active NPI Family Medicine Physician · Fairfield, OH
NPI 1770070831 · NPPES record last updated May 14, 2025
Key facts
- NPI
- 1770070831
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 34.014228 (OH)
- Practice address
- 2960 Mack Rd Ste 110
Fairfield, OH 45014-5373 - Phone
- (513) 296-8090
- NPI assigned
- Apr 15, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Edward Via Col of Osteo Medicine-Virginia Campus, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Health Physicians Cincinnati LLC
Practice addresses (Care Compare)
2446 Kipling Ave
Cincinnati, OH 45239-6650
Phone (513) 583-8500
Hospital & facility affiliations
- Mercy Health - Fairfield Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210610002941 | OH | Practitioner - Family Practice | 8224387824 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34.014228 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alliance Physicians Inc | Family Medicine | Current |
Accepting new patients |
| Mercy Health Physicians Cincinnati LLC | Current |
Accepting new patients | |
| Mercy Health Physicians Cincinnati, LLC | Family Medicine | Current |
Accepting new patients |
| Alliance Physicians Inc | Current |
Accepting new patients | |
| Mercy Health - Fairfield Hospital LLC | Past |
Accepting new patients |
Locations
2446 Kipling Ave
Cincinnati, OH 45239
Phone (513) 583-8500
7740 Washington Village Dr
Ste 130
Dayton, OH 45459
Phone (513) 932-4891
405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200
2960 Mack Rd
Ste 110
Fairfield, OH 45014
Phone (513) 296-8090
1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306
1 E National Rd
Ste 100
Vandalia, OH 45377
Phone (937) 350-6700
1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534
Interoperability endpoints
- sjohnson2846681@direct.bsmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34.014228 | OH | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X | OH |
Addresses
Primary practice location
2960 Mack Rd Ste 110
Fairfield, OH 45014-5373
Mailing address
1 Prestige PL Ste 550
Miamisburg, OH 45342-6115
Phone (937) 762-1310
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sjohnson598265@direct.ketteringhealth.org | ||
| FHIR URL | https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/ |
Other providers in Fairfield, OH
- Devenia Lynn Johnson
- Dominique Johnson
- Jnae Johnson
- Joshua Johnson
- Robert Harley Johnson
- Amy Marie Jolivette
- Tyrel Jones May
- Blake Jones
- Gloria Jones
- Holly Jones
All providers in Fairfield, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.