Individual provider Active NPI

Garner Johnson, MD

  • Colon & Rectal Surgery Physician
  • Albany, NY
National Provider Identifier
1801948377
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
179502 Issued in NY
Practice address
319 S Manning Blvd
Suite 310
Albany, NY 12208-1742
Phone
(518) 438-2776
NPI assigned
Jan 17, 2007
Last updated
May 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 179502 NY Primary

Addresses

Primary practice location

319 S Manning Blvd
Suite 310
Albany, NY 12208-1742

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

319 S Manning Blvd Ste 310
Albany, NY 12208
Phone (518) 438-2776

Other practice location 2

855 Route 146
Clifton Park, NY 12065
Phone (518) 438-2776

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20110726000578 NY Practitioner - Colorectal Surgery (Proctology) 8527236199 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter's Health Partners Medical Associates, P.C. CurrentSince Jan 1, 2020 Accepting new patients

Locations

319 S Manning Blvd
Ste 310
Albany, NY 12208
Phone (518) 438-2776

855 Route 146
Clifton Park, NY 12065
Phone (518) 438-2776

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

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, 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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1801948377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 S MANNING BLVD",
            "address_2": "SUITE 310",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081742",
            "telephone_number": "518-438-2776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "319 S Manning Blvd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "12208",
            "country_code": "US",
            "telephone_number": "518-438-2776",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "855 Route 146",
            "address_purpose": "LOCATION",
            "city": "Clifton Park",
            "state": "NY",
            "postal_code": "12065",
            "country_code": "US",
            "telephone_number": "518-438-2776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GARNER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "179502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPH Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "319 S Manning Blvd Ste 310",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "12208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.