Individual provider Active NPI

Jeffrey J Johnson, M.D.

  • Emergency Medicine Physician
  • Lancaster, NH
National Provider Identifier
1902817307
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
042-0008782 Issued in VT
Practice address
173 Middle St
Lancaster, NH 03584-3508
Phone
(603) 788-4911
Fax
(603) 788-5031
NPI assigned
Aug 10, 2006
Last updated
Mar 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 042-0008782 VT Primary
Emergency Medicine Physician 207P00000X 10082 NH

Addresses

Primary practice location

173 Middle St
Lancaster, NH 03584-3508

Mailing address

173 Middle St
Lancaster, NH 03584-3508
Phone (603) 788-4911

Other identifiers 2

IdentifierTypeStateIssuer
3073610MedicaidNH
0VN0703MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20230524003558 NM Practitioner - Internal Medicine 1153357439 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042-0008782VTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nextcare New Mexico LLC CurrentSince Apr 13, 2023 Accepting new patients

Locations

8201 Golf Course Rd NW
Albuquerque, NM 87120
Phone (505) 800-7070

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1902817307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 MIDDLE ST",
            "city": "LANCASTER",
            "state": "NH",
            "postal_code": "035843508",
            "telephone_number": "603-788-4911",
            "fax_number": "603-788-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 MIDDLE ST",
            "city": "LANCASTER",
            "state": "NH",
            "postal_code": "035843508",
            "telephone_number": "603-788-4911",
            "fax_number": "603-788-5031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEFFREY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VT",
            "license": "042-0008782",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NH",
            "license": "10082",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3073610",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN0703",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, NH

Sources for this page

Verify at the official NPI Registry.