Individual provider Active NPI

Eric Gordon Johnson, MD

  • Family Medicine Physician
  • Rock Hill, SC
National Provider Identifier
1871550558
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9691 Issued in SC
Practice address
200 S Herlong Ave
Suite B
Rock Hill, SC 29732-3399
Phone
(803) 325-1770
Fax
(803) 325-1790
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2012

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 9691 SC Primary

Addresses

Primary practice location

200 S Herlong Ave
Suite B
Rock Hill, SC 29732-3399

Mailing address

200 S Herlong Ave
Suite B
Rock Hill, SC 29732-3399
Phone (803) 325-1770

Other identifiers 2

IdentifierTypeStateIssuer
890631KMedicaidNC
096915MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20060509000442 SC Practitioner - Family Practice 8224049986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Jefferson Medical College of Thomas Jefferson University, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Physician Network LLCGroup PAC ID 7911287552, 92 clinicians

Practice addresses (Care Compare)

2633 Celanese Rd
Rock Hill, SC 29732-1205
Phone (803) 325-1770

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Physician Network LLC Family Medicine CurrentSince Oct 23, 2017 Accepting new patients

Locations

2633 Celanese Rd
Rock Hill, SC 29732
Phone (803) 325-1770

200 Herlong Ave S
Ste B
Rock Hill, SC 29732
Phone (803) 324-1950

200 Herlong Ave S
Ste E
Rock Hill, SC 29732
Phone (803) 324-1950

200 Herlong Ave S
Ste G
Rock Hill, SC 29732
Phone (803) 325-1770

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14929/brand/3/csg/1/fhir/r4
  • Direct secure messaging: eric.johnson.1@14929.direct.athenahealth.com

Organizations & group practices 1

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 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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1871550558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S HERLONG AVE",
            "address_2": "SUITE B",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323399",
            "telephone_number": "803-325-1770",
            "fax_number": "803-325-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S HERLONG AVE",
            "address_2": "SUITE B",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323399",
            "telephone_number": "803-325-1770",
            "fax_number": "803-325-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ERIC",
        "middle_name": "GORDON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "9691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890631K",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096915",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.