Active NPI
Steven Paul Johnson, MD
- Family Medicine Physician
- New London, CT
National Provider Identifier
1902801434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 27140
- Practice address
- 4 Shaws CV
Ste 103
New London, CT 06320-4956 - Phone
- (860) 443-3778
- Fax
- (860) 443-8820
- NPI assigned
- Jun 21, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 27140 | CT | Primary |
Addresses
Primary practice location
4 Shaws CV
Ste 103
New London, CT 06320-4956
Mailing address
4 Shaws CV
Ste 103
New London, CT 06320-4956
Phone (860) 443-3778
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004071320 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital Internists of New London, LLC | Past | Accepting new patients |
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.
-
- Hospitalist Physician
- New London, CT
- NPI 1659393775
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902801434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 SHAWS CV",
"address_2": "STE 103",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063204956",
"telephone_number": "860-443-3778",
"fax_number": "860-443-8820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 SHAWS CV",
"address_2": "STE 103",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063204956",
"telephone_number": "860-443-3778",
"fax_number": "860-443-8820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "STEVEN",
"middle_name": "PAUL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CT",
"license": "27140",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004071320",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in New London, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.