NPIMap

Individual provider Active NPI

Matthew B Johnson, DO

  • Internal Medicine Physician
  • Harlan, KY
National Provider Identifier
1811512494
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
05495 Issued in KY
Practice address
37 Ball Park Rd
Harlan, KY 40831-1701
Phone
(606) 573-4520
Fax
(606) 573-6392
NPI assigned
Jun 10, 2020
Last updated
Aug 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0116034070 VA
Internal Medicine Physician 207R00000X 05495 KY Primary

Addresses

Primary practice location

37 Ball Park Rd
Harlan, KY 40831-1701

Mailing address

37 Ball Park Rd
Harlan, KY 40831-1701
Phone (606) 573-4520

Other practice location 1

100 15th St NW
Norton, VA 24273-1616
Phone (276) 679-3488

Other identifiers 1

IdentifierTypeStateIssuer
7100907190MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mjohnson29@arh.medalliesdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230725000797 KY Practitioner - Internal Medicine 2466879267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

37 Ball Park Rd
Harlan, KY 40831-1701
Phone (606) 573-4520

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.15 of 100Reported as apm
Quality
47.14
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Regional Healthcare, Inc CurrentSince Aug 1, 2023 Accepting new patients
Appalachian Regional Healthcare, Inc CurrentSince Aug 1, 2023 Accepting new patients
Appalachian Regional Healthcare, Inc Current Accepting new patients
Appalachian Regional Healthcare, Inc. Past Accepting new patients

Locations

37 Ball Park Rd
Harlan, KY 40831
Phone (606) 263-3900

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1811512494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 BALL PARK RD",
            "city": "HARLAN",
            "state": "KY",
            "postal_code": "408311701",
            "telephone_number": "606-573-4520",
            "fax_number": "606-573-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 BALL PARK RD",
            "city": "HARLAN",
            "state": "KY",
            "postal_code": "408311701",
            "telephone_number": "606-573-4520",
            "fax_number": "606-573-6392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 15th St NW",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "242731616",
            "country_code": "US",
            "telephone_number": "276-679-3488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MATTHEW",
        "middle_name": "B",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-10",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0116034070",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "05495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100907190",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjohnson29@arh.medalliesdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Standard Direct Functionality",
            "address_1": "37 Ball Park Rd",
            "city": "Harlan",
            "state": "KY",
            "country_code": "US",
            "postal_code": "408311701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harlan, KY

Sources for this page

Verify at the official NPI Registry.