Active NPI
Donald Johnston, D.O.
- Orthopaedic Surgery Physician
- Belleville, IL
National Provider Identifier
1811003056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 036-099381
- Practice address
- 4700 Memorial Dr
Suite 340
Belleville, IL 62226-5373 - Phone
- (618) 234-9884
- Fax
- (618) 235-9020
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 036-099381 | IL | Primary |
Addresses
Primary practice location
4700 Memorial Dr
Suite 340
Belleville, IL 62226-5373
Mailing address
4500 Memorial Drive
Memorial Hospital Med Affairs Credentialing Dept
Belleville, IL 62226
Phone (618) 257-4644
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-099381 | IL | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Heights Medical Group SC | Past | Accepting new patients |
Interoperability endpoints
- djohnston170966@direct.carenet.org
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1679503668
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458518400000",
"number": "1811003056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 MEMORIAL DRIVE",
"address_2": "MEMORIAL HOSPITAL MED AFFAIRS CREDENTIALING DEPT",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "62226",
"telephone_number": "618-257-4644",
"fax_number": "618-257-6946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 MEMORIAL DR",
"address_2": "SUITE 340",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265373",
"telephone_number": "618-234-9884",
"fax_number": "618-235-9020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "DONALD",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2016-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "IL",
"license": "036-099381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.