Active NPI
William Earle Johnson III, M.D.
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Mobile, AL
National Provider Identifier
1770581589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 00012735
- Practice address
- 1855 Springhill Ave
Mobile, AL 36607-2301 - Phone
- (251) 471-3544
- Fax
- (251) 476-7254
- NPI assigned
- Jul 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 00012735 | AL | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 00012735 | AL | Primary |
Addresses
Primary practice location
1855 Springhill Ave
Mobile, AL 36607-2301
Mailing address
1855 Springhill Ave
Mobile, AL 36607-2301
Phone (251) 471-3544
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000016030 | Medicaid | AL | |
| 510-16030 | Other | AL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 96.5 of 100
- Promoting interoperability
- 90
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00012735 | AL | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Pathology Associates Inc | Current | Accepting new patients |
Locations
302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940
Interoperability endpoints
- wjohnson15094@directinfirmaryhealth.org
Organizations & group practices 1
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.
-
- Anatomic Pathology & Clinical Pathology Physician
- Aiken, SC
- NPI 1275631715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464220800000",
"number": "1770581589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1855 SPRINGHILL AVE",
"city": "MOBILE",
"state": "AL",
"postal_code": "366072301",
"telephone_number": "251-471-3544",
"fax_number": "251-476-7254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1855 SPRINGHILL AVE",
"city": "MOBILE",
"state": "AL",
"postal_code": "366072301",
"telephone_number": "251-471-3544",
"fax_number": "251-476-7254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "WILLIAM",
"middle_name": "EARLE",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-14",
"last_updated": "2016-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "AL",
"license": "00012735",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "AL",
"license": "00012735",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000016030",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "510-16030",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.