Individual provider Active NPI

Frederick C Johlin Jr., MD

  • Gastroenterology Physician
  • Iowa City, IA
National Provider Identifier
1821085960
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
23554 Issued in IA
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 356-4901
Fax
(319) 384-8559
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 23554 IA
Hepatology Physician 207RI0008X 23554 IA
Gastroenterology Physician 207RG0100X 23554 IA Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-4901

Other identifiers 2

IdentifierTypeStateIssuer
21585OtherIAWELLMARK BCBS
0215855MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20100910000059 IA Practitioner - GastroenterologyPractitioner - Internal Medicine 3971628207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.02 of 100Reported as group
Quality
75.68
Promoting interoperability
78
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23554IAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State University of Iowa Internal Medicine CurrentSince Jun 20, 1984 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

200 Hawkins Dr
#4553
Iowa City, IA 52242
Phone (319) 356-3108

200 Hawkins Dr
#H
Iowa City, IA 52242
Phone (319) 356-1616

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616

Interoperability endpoints

  • Direct secure messaging: fjohlin1859@uihcdirect.org

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1821085960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-4901",
            "fax_number": "319-384-8559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-4901",
            "fax_number": "319-384-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHLIN",
        "first_name": "FREDERICK",
        "middle_name": "C",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "23554",
            "primary": false
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "IA",
            "license": "23554",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IA",
            "license": "23554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "21585",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0215855",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.