Miles David Johnson, MD PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MILES DAVID JOHNSON, MD PC

Practice address

150 Fiddlers RDG
Fayetteville, GA 30214-2684

Phone

(404) 664-4578

Fax

(770) 991-5012

NPI assigned

Mar 2, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Miles David Johnson, M. D.

Title

Ceo

Phone

(404) 664-4578

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1801256946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 FIDDLERS RDG",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 FIDDLERS RDG",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142684",
            "telephone_number": "404-664-4578",
            "fax_number": "770-991-5012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILES DAVID JOHNSON, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-02",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MILES",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-664-4578",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0622729N",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dianne Michelson
• Darien Middleton, RBT
• Donna-Lee Mighty-Moore
• Eleasa Milano, APRN
• Terri Milburn, FNP-BC
• Miles Medical Supplies
• Angela Miller, FNP
• Brittney Miller, FNP-C
• Robin A. Miller, OT
• Corey Milsap, PSYD, LPC

• Family Medicine Physician in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.