Active NPI
Donald R Johnson, M.D.
- Gastroenterology Physician
- Fort Worth, TX
National Provider Identifier
1790745990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- G5938
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 114077401 | Medicaid | TX | |
| 84Y113 | Other | TX | BCBSTX |
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heartplace, PLLC | Past | Accepting new patients |
Interoperability endpoints
- 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.
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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.