Individual provider Active NPI

Nicole Alexis Johnson, M.D.

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1902288020
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R7490 Issued in TX
Practice address
3450 W Camp Wisdom Rd
Dallas, TX 75237-2515
Phone
(214) 645-7500
NPI assigned
Jun 25, 2015
Last updated
Jan 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R7490 TX Primary

Addresses

Primary practice location

3450 W Camp Wisdom Rd
Dallas, TX 75237-2515

Mailing address

PO Box 845347
Dallas, TX 75284-7208
Phone (214) 645-7500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address njohnson336630@direct.sw.org

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
I20180917000821 TX Practitioner - Internal Medicine 0941506281 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Meharry Medical College School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3450 W Camp Wisdom Rd
Dallas, TX 75237-2504
Phone (214) 214-5820

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R7490TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Aug 10, 2021 Accepting new patients
Healthtexas Provider Network Internal Medicine Current Accepting new patients
Healthtexas Provider Network Internal Medicine CurrentSince Aug 10, 2021 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 3, 2024 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 3, 2024 Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

3600 Gaston Ave
Ste 656
Dallas, TX 75246
Phone (214) 820-3466

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

3450 W Camp Wisdom Rd
Dallas, TX 75237
Phone (214) 214-5820

2005 W Park Dr
Ste 300
Irving, TX 75061
Phone (469) 800-1050

Interoperability endpoints

  • Direct secure messaging: njohnson336630@direct.sw.org

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

Hospital & facility affiliations 1

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": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1902288020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847208",
            "telephone_number": "214-645-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 W CAMP WISDOM RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752372515",
            "telephone_number": "214-645-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICOLE",
        "middle_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R7490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "njohnson336630@direct.sw.org",
            "affiliation": "N",
            "address_1": "2005 W Park Dr Ste 300",
            "city": "Irving",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750612034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.