Paul M Johnson, MD

Primary specialty

Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X

License

ME160203 Issued in FL

Practice address

311 N Clyde Morris Blvd
Daytona Beach, FL 32114-2781

Phone

(386) 425-4267

Fax

(386) 425-4879

NPI assigned

Oct 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in ND, AZ, FL3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Sports MedicineAlso: Undersea and Hyperbaric Medicine

Education

University of North Dakota School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Halifax Healthcare Systems IncGroup PAC ID 1254238090, 345 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trilogy Home Healthcare Home health agency, Jacksonville, FL, CCN 107689
• Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017
• Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: paul.johnson.1@16462.direct.athenahealth.com

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.

• Halifax Healthcare Systems Inc

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1245283530

  Sports Medicine

  Medicare reassignment Care Compare group NPD
• Kingman Healthcare, Inc

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917

  Sports Medicine

  Medicare reassignment NPD
• Mercy Hospital of Devils Lake

  • Emergency Medicine Physician
  • Devils Lake, ND
  • NPI 1790751170
  Medicare reassignment NPD
• Kingman Healthcare, Inc

  • Community/Retail Pharmacy
  • Kingman, AZ
  • NPI 1992286298
  NPD
• Mercy Hospital of Devils Lake

  • Clinic/Center
  • Devils Lake, ND
  • NPI 1184117293
  NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)
• Sidney Health Center

  • Community/Retail Pharmacy
  • Sidney, MT
  • NPI 1497743959
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Altercare LLC

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1871529347
  Care Compare affiliation
• Halifax Hospital Medical Center

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1811991227
  Care Compare affiliation
• Memorial Health Systems Inc

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1063426823
  Care Compare affiliation
• Memorial Health Systems Inc

  • Clinical Medical Laboratory
  • Daytona Beach, FL
  • NPI 1104696178

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1780767616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 25TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594056010",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142781",
            "telephone_number": "386-425-4267",
            "fax_number": "386-425-4879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAUL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "FL",
            "license": "ME160203",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME160203",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000093475",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080192535",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0058327",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12219",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kierra Johnson, RPH
• Lindsey Alan Johnson, MD
• Marla D Johnson, LMHC
• Martha Johnson
• Onisha Johnson
• Raven Johnson
• Shanikwa Johnson, APRN
• Star Johnson
• Tamia Denise Johnson
• Tatyana Johnson

• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.