Individual provider Active NPI

Mary Caitlyn Johnson, MD

  • Family Medicine Physician
  • Birmingham, AL
National Provider Identifier
1831779701
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
45304 Issued in AL
Practice address
1308 Tuscaloosa Ave SW
Birmingham, AL 35211-1948
Phone
(205) 679-6325
NPI assigned
Apr 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 45304 AL Primary

Addresses

Primary practice location

1308 Tuscaloosa Ave SW
Birmingham, AL 35211-1948

Mailing address

1308 Tuscaloosa Ave SW
Birmingham, AL 35211-1948
Phone (205) 679-6325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20240614002118 AL Practitioner - Family Practice 3274937321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Alabama School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Whatley Health Services IncGroup PAC ID 8224921705, 84 clinicians
Capstone Health Services Foundation PCGroup PAC ID 6103724489, 159 clinicians

Practice addresses (Care Compare)

2731 ML King Jr Blvd
Tuscaloosa, AL 35401-5235
Phone (205) 758-6647

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7457
Phone (205) 348-1770

Hospital & facility affiliations

  • DCH Regional Medical Center Hospital, Tuscaloosa, AL, CCN 010092

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45304ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Whatley Health Services Inc CurrentSince Aug 1, 2024 Accepting new patients
Capstone Health Services Foundation PC CurrentSince Jul 1, 2024 Accepting new patients
Whatley Health Services, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Capstone Health Services Foundation PC Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
The DCH Healthcare Authority Past Accepting new patients

Locations

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

2731 Ml King Jr Blvd
Tuscaloosa, AL 35401
Phone (205) 349-3250

850 Peter Bryce Blvd
Tuscaloosa, AL 35401

Interoperability endpoints

  • Direct secure messaging: mary.johnson.p1@direct.umc.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1831779701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 TUSCALOOSA AVE SW",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352111948",
            "telephone_number": "205-679-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 TUSCALOOSA AVE SW",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352111948",
            "telephone_number": "205-679-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARY",
        "middle_name": "CAITLYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "45304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.