Individual provider Active NPI

William Earle Johnson III, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Mobile, AL
National Provider Identifier
1770581589
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
00012735 Issued in AL
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

Updated by the provider on May 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
000016030MedicaidAL
510-16030OtherALBLUE 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 Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.5 of 100Reported as group
Promoting interoperability
90
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00012735ALMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Pathology Associates Inc Current Accepting new patients

Locations

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.