Individual provider Active NPI

Nicholas Tovera Johnson, M.D.

  • Emergency Medicine Physician
  • Gainesville, GA
National Provider Identifier
1902025653
Registry record updated Jan 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
76417 Issued in GA
Practice address
743 Spring St NE
Gainesville, GA 30501-3715
Phone
(770) 219-9000
NPI assigned
Apr 24, 2007
Last updated
Jan 8, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036117169 IL
Emergency Medicine Physician 207P00000X 01063115A IN
Emergency Medicine Physician 207P00000X 76417 GA Primary

Addresses

Primary practice location

743 Spring St NE
Gainesville, GA 30501-3715

Mailing address

511 Ebenezer Church Rd
Jefferson, GA 30549-4525
Phone (773) 791-2983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20161021001742 GA Practitioner - Emergency Medicine 3870681141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Emergency Department Services, P.C.Group PAC ID 5597751032, 76 clinicians

Practice addresses (Care Compare)

1400 River PL
Braselton, GA 30517-5600
Phone (770) 219-9000

743 Spring Nest
Gainesville, GA 30501-3715
Phone (770) 503-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.02 of 100Reported as group
Quality
91.38
Improvement activities
40
Cost
79.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76417GAMDEmergency Medicine Physician
036117169ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Emergency Department Services, P.C. Emergency Medicine CurrentSince Oct 1, 2016 Accepting new patients

Locations

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483833600000",
    "number": "1902025653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 EBENEZER CHURCH RD",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305494525",
            "telephone_number": "773-791-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-219-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICHOLAS",
        "middle_name": "TOVERA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2017-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036117169",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01063115A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "76417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.