Individual provider Active NPI

Katharine M Johnson, MD

  • Neonatal-Perinatal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1790985984
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
P2693 Issued in TX
Practice address
5430 Fredericksburg Rd Ste 508
San Antonio, TX 78229-3561
Phone
(210) 541-8281
Fax
(210) 541-9123
NPI assigned
Jul 25, 2007
Last updated
Dec 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD12958 RI
Neonatal-Perinatal Medicine Physician 2080N0001X P2693 TX Primary

Addresses

Primary practice location

5430 Fredericksburg Rd Ste 508
San Antonio, TX 78229-3561

Mailing address

5430 Fredericksburg Rd Ste 508
San Antonio, TX 78229-3561
Phone (210) 541-8281

Other practice location 1

5414 Fredericksburg Rd
Suite 100
San Antonio, TX 78229-3641
Phone (210) 541-8281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120814000112 TX Practitioner - Pediatric MedicinePractitioner - Other (Physician) 7113194523 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD12958RIMDPediatrics Physician
P2693TXMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magella Medical Associates Billing, Inc. Neonatal-Perinatal Medicine CurrentSince Sep 1, 2012 Accepting new patients
Methodist Healthcare System of San Antonio, LTD., L.L.P. Past Accepting new patients
Christus Santa Rosa Health Care Corporation Past Accepting new patients
VHS San Antonio Partners LLC Past Accepting new patients
Methodist Healthcare System of San Antonio LTD LLP Past Accepting new patients
VHS San Antonio Partners, LLC Past Accepting new patients

Locations

551 Hill Country Dr
Kerrville, TX 78028
Phone (830) 257-5414

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

3001 George Bush Hwy
Ste 250
Richardson, TX 75082
Phone (888) 822-2855

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

11212 State Highway 151
San Antonio, TX 78251
Phone (210) 281-5066

1139 E Sonterra Blvd
San Antonio, TX 78258
Phone (210) 638-2000

1310 McCullough Ave
San Antonio, TX 78212
Phone (210) 208-2200

3011 W Loop 1604 N
San Antonio, TX 78251
Phone (726) 266-7081

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

3333 Research Plz
San Antonio, TX 78235
Phone (210) 297-3000

5106 W Loop 1604 N
San Antonio, TX 78251
Phone (210) 575-0355

5414 Fredericksburg Rd
Ste 100
San Antonio, TX 78229
Phone 2105418281 ext. 221

5430 Fredericksburg Rd
Ste 508
San Antonio, TX 78229
Phone 2105418281 ext. 221

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

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.

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1790985984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5430 FREDERICKSBURG RD STE 508",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293561",
            "telephone_number": "210-541-8281",
            "fax_number": "210-541-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 FREDERICKSBURG RD STE 508",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293561",
            "telephone_number": "210-541-8281",
            "fax_number": "210-541-9123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5414 Fredericksburg Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293641",
            "country_code": "US",
            "telephone_number": "210-541-8281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHARINE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "MD12958",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TX",
            "license": "P2693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.