NPIMap

Individual provider Active NPI

Gina A Johnston, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Germantown, TN
National Provider Identifier
1790759850
Registry record updated Feb 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
28387 Issued in TN
Practice address
7550 Wolf River Blvd Ste 200
Germantown, TN 38138-1778
Phone
(901) 542-6801
NPI assigned
Feb 15, 2006
Last updated
Feb 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 28387 TN Primary

Addresses

Primary practice location

7550 Wolf River Blvd Ste 200
Germantown, TN 38138-1778

Mailing address

PO Box 1483
Indianapolis, IN 46206-1483
Phone (662) 470-1110

Other identifiers 2

IdentifierTypeStateIssuer
3880737MedicaidTN
149765001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AR, MS3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20110524000432 TN Practitioner - Pathology 3173709342 Reassigns benefits to 2 organizations
I20111207000731 AR Practitioner - Pathology 3173709342 Reassigns benefits to 2 organizations
I20200305000879 MS Practitioner - Pathology 3173709342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Tennessee, HSC, College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Specialists of Memphis PCGroup PAC ID 5193117364, 15 clinicians

Practice addresses (Care Compare)

1265 Union Ave
Memphis, TN 38104-3415
Phone (901) 516-7182

4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone (901) 516-7182

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Surgery Center Germantown LP Current Accepting new patients
Pathology Specialists of Memphis PC CurrentSince Feb 10, 2023 Accepting new patients
Doctors' Anatomic Pathology Services, PA Anatomic Pathology & Clinical Pathology Current Accepting new patients

Locations

411 E Matthews Ave
Jonesboro, AR 72401
Phone (501) 932-7430

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

1265 Union Ave
#6
Memphis, TN 38104
Phone (901) 726-2305

1363 S Germantown Rd
Memphis, TN 38138
Phone (901) 516-6000

Interoperability endpoints

  • Direct secure messaging: gjohnston26326@mlh.direct-ci.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 3

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1790759850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1483",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061483",
            "telephone_number": "662-470-1110",
            "fax_number": "317-705-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7550 WOLF RIVER BLVD STE 200",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381778",
            "telephone_number": "901-542-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "GINA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "28387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3880737",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149765001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.