NPIMap

Individual provider Active NPI

Roger F Johnson, MD

  • Pulmonary Disease Physician
  • Evansville, IN
National Provider Identifier
1780624742
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
01061986A Issued in IN
Practice address
901 Saint Marys Dr Ste 200
Evansville, IN 47714
Phone
(812) 485-6030
NPI assigned
Jun 7, 2006
Last updated
Jul 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 01061986A IN
Pulmonary Disease Physician 207RP1001X 01061986A IN Primary

Addresses

Primary practice location

901 Saint Marys Dr Ste 200
Evansville, IN 47714

Mailing address

901 Saint Marys Dr Ste 200
Evansville, IN 47714-0509

Other identifiers 4

IdentifierTypeStateIssuer
64056310MedicaidKY
000000489925OtherINANTHEM
P00377506OtherINRAILROAD MEDICARE
200821580MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address roger.johnson.1@7598.direct.athenahealth.com St Mary's Medical Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20061005000145 IN Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 9032004767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Northwestern University Feinberg Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Practice addresses (Care Compare)

1314 E Walnut St
Washington, IN 47501-2860
Phone (812) 254-8892

3700 Washington Ave
Evansville, IN 47714-0541

801 Saint Marys Dr
505E
Evansville, IN 47714-0528
Phone (812) 491-3236

901 Saint Marys Dr
Suite 400
Evansville, IN 47714-0520
Phone (812) 485-6030

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01061986AINMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary's Medical Group, LLC Pulmonary Disease CurrentSince Feb 25, 2014 Accepting new patients
Primary Physicians Network LLC Current Accepting new patients
St Mary's Medical Group, LLC CurrentSince Feb 25, 2014 Accepting new patients
St. Mary's Health, Inc Past Accepting new patients
St. Mary's Physician Network LLC. Pulmonary Disease PastSince Apr 30, 2003 Accepting new patients
Mid-State Physicians, LLC Past Accepting new patients

Locations

100 S Rosenberger Ave
Ste B100
Evansville, IN 47712
Phone (812) 479-3125

100 S Rosenberger Ave
Ste B200
Evansville, IN 47712
Phone (812) 433-2000

14020 Old State Rd
Ste C500
Evansville, IN 47725
Phone (812) 485-6030

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236

901 Saint Marys Dr
Ste 200
Evansville, IN 47714
Phone (812) 485-6030

7839 S Professional Dr
Fort Branch, IN 47648
Phone (812) 753-5903

1314 E Walnut St
Washington, IN 47501
Phone (812) 254-2250

Interoperability endpoints

  • Direct secure messaging: roger.johnson.1@7598.direct.athenahealth.com

Organizations & group practices 6

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 9

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1780624742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 SAINT MARYS DR STE 200",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SAINT MARYS DR STE 200",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47714",
            "telephone_number": "812-485-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROGER",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01061986A",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01061986A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64056310",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000489925",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00377506",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200821580",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "roger.johnson.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "901 Saint Marys Dr Ste 200",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "47714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.