Individual provider Active NPI

David Bryan Johnson, MD

  • Family Medicine Physician
  • Chattanooga, TN
National Provider Identifier
1811974926
Registry record updated Oct 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
049908 Issued in GA
Practice address
4411 Oakwood Dr
Chattanooga, TN 37416-2367
Phone
(423) 892-4289
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2015

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 049908 GA Primary

Addresses

Primary practice location

4411 Oakwood Dr
Chattanooga, TN 37416-2367

Mailing address

3310 West End Ave 590
Nashville, TN 37203-1260
Phone (615) 913-5086

Other identifiers 5

IdentifierTypeStateIssuer
0102830OtherGAUNITED HEALTHCARE
841074OtherGABLUE CROSS BLUE SHIELD
000905121COtherGAMEDICAID GA
89064FNOtherNCMEDICAID NC
P00048268OtherGARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2026 through Apr 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
049908GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Health Medical Partners of Middle Tennessee PC Family Medicine PastSince Jun 1, 2014 Accepting new patients
Chatuge Regional Hospital Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24009/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1811974926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 WEST END AVE 590",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031260",
            "telephone_number": "615-913-5086",
            "fax_number": "888-494-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 OAKWOOD DR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374162367",
            "telephone_number": "423-892-4289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "BRYAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "049908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0102830",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "841074",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GA",
            "identifier": "000905121C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID NC",
            "identifier": "89064FN",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00048268",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.