Individual provider Active NPI

Joe Stanley Johnson, MD

  • Family Medicine Physician
  • Cleburne, TX
National Provider Identifier
1801893474
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E4434 Issued in TX
Practice address
805 N Main St
Cleburne, TX 76033-3816
Phone
(817) 202-3976
Fax
(817) 202-3978
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E4434 TX Primary

Addresses

Primary practice location

805 N Main St
Cleburne, TX 76033-3816

Mailing address

220 N Ridgeway Dr
Cleburne, TX 76033-4148
Phone (817) 556-4800

Other practice location 1

109 E Godley Ave
Godley, TX 76044-3787
Phone (682) 289-0427

Other identifiers 1

IdentifierTypeStateIssuer
126888003MedicaidTX

Other names 1

  • J Stan Johnson Professional name

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
I20090115000638 TX Practitioner - Family PracticePractitioner - General PracticePractitioner - Other (Physician) 1355404831 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cfma Denton PLLC Family Medicine Current Accepting new patients
McDavid M Mahaffey MD PA -Godley Family Medicine PastSince Feb 25, 2024 Accepting new patients
McDavid M. Mahaffey, M.D., P.a. Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: joe.johnson.1@24667.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/24667/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1801893474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N RIDGEWAY DR",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760334148",
            "telephone_number": "817-556-4800",
            "fax_number": "817-556-4825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N MAIN ST",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760333816",
            "telephone_number": "817-202-3976",
            "fax_number": "817-202-3978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 E Godley Ave",
            "address_purpose": "LOCATION",
            "city": "Godley",
            "state": "TX",
            "postal_code": "760443787",
            "country_code": "US",
            "telephone_number": "682-289-0427",
            "fax_number": "817-202-3978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOE",
        "middle_name": "STANLEY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E4434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126888003",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J",
            "last_name": "JOHNSON",
            "middle_name": "STAN",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Cleburne, TX

Sources for this page

Verify at the official NPI Registry.