Individual provider Active NPI

Douglas Robert Johnson, D.O.

  • Cardiovascular Disease Physician
  • Waco, TX
National Provider Identifier
1841464153
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
Q6854 Issued in TX
Practice address
50 Hillcrest Medical Blvd Ste 303
Waco, TX 76712-8955
Phone
(254) 202-0480
Fax
(254) 202-0488
NPI assigned
Apr 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Q6854 TX Primary

Addresses

Primary practice location

50 Hillcrest Medical Blvd Ste 303
Waco, TX 76712-8955

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Other practice location 1

900 8th Ave
Fort Worth, TX 76104-3902
Phone (954) 629-3621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220523001603 TX Practitioner - Cardiovascular Disease (Cardiology) 1153656640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Nova Southeastern College of Osteo Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

100 Hillcrest Med Blvde
Waco, TX 76712-8897
Phone (254) 202-5800

140 Hillcrest Medical Blvd
Waco, TX 76712-8897
Phone (254) 202-8330

150 Hillcrest Medical Blvd
Waco, TX 76712-8897
Phone (254) 202-4000

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

300 University Blvd
Round Rock, TX 78665-1032
Phone (512) 509-0200

302 University Blvd
Round Rock, TX 78665-1032
Phone (512) 509-0200

50 Hillcrest Medical Blvd
Suite 201B
Waco, TX 76712-8954
Phone (254) 297-0515

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

  • Baylor Scott & White Medical Center Hillcrest Hospital, Waco, TX, CCN 450101
  • Baylor Scott & White Medical Center - Temple Hospital, Temple, TX, CCN 450054

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q6854TXMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic CurrentSince Jun 1, 2022 Accepting new patients
Scott & White Clinic Current Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

1280 Arrington Rd
Ste 200
College Station, TX 77845
Phone (979) 207-6550

1701 E Pflugerville Pkwy
Pflugerville, TX 78660
Phone (512) 259-6000

2401 S 31st St
#200
Temple, TX 76508
Phone (254) 215-0100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

50 Hillcrest Medical Blvd
Ste 303
Waco, TX 76712
Phone (254) 202-0480

Interoperability endpoints

  • Direct secure messaging: djohnson1104090@direct.sw.org

Organizations & group practices 3

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": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1841464153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 HILLCREST MEDICAL BLVD STE 303",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128955",
            "telephone_number": "254-202-0480",
            "fax_number": "254-202-0488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761043902",
            "country_code": "US",
            "telephone_number": "954-629-3621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DOUGLAS",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-17",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "Q6854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.