Individual provider Active NPI

Donald R Johnson, M.D.

  • Gastroenterology Physician
  • Fort Worth, TX
National Provider Identifier
1790745990
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G5938 Issued in TX
Practice address
1111 5TH Ave
Fort Worth, TX 76104-4302
Phone
(817) 877-0888
Fax
(817) 877-5039
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X G5938 TX Primary

Addresses

Primary practice location

1111 5TH Ave
Fort Worth, TX 76104-4302

Mailing address

7610 Stemmons Fwy
Suite 500
Dallas, TX 75247-4231
Phone (214) 689-5960

Other identifiers 2

IdentifierTypeStateIssuer
114077401MedicaidTX
84Y113OtherTXBCBSTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Heartplace, PLLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14273/brand/6/csg/1/fhir/r4

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274832000000",
    "number": "1790745990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7610 STEMMONS FWY",
            "address_2": "SUITE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474231",
            "telephone_number": "214-689-5960",
            "fax_number": "214-630-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 5TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044302",
            "telephone_number": "817-877-0888",
            "fax_number": "817-877-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DONALD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2010-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "G5938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114077401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "84Y113",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.