Active NPI
Paul R Johnson, M.D.
- General Practice Physician
- Chestertown, MD
National Provider Identifier
1902830433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- D0052487
- Practice address
- 400 S Cross St
Suite 1
Chestertown, MD 21620-4752 - Phone
- (410) 778-0088
- Fax
- (410) 778-9592
- NPI assigned
- Jul 10, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | D0052487 | MD | |
| General Practice Physician | 208D00000X | D0052487 | MD | Primary |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | D0052487 | MD |
Addresses
Primary practice location
400 S Cross St
Suite 1
Chestertown, MD 21620-4752
Mailing address
PO Box 1079
Chestertown, MD 21651
Phone (410) 778-0088
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0052487 | MD | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Vein Restoration MD LLC | Vascular Surgery | Past | Accepting new patients |
| Gerard S. O'Connor,M.D. | Vascular Surgery | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Vascular Surgery Physician
- Greenbelt, MD
- NPI 1487772349
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204243200000",
"number": "1902830433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1079",
"city": "CHESTERTOWN",
"state": "MD",
"postal_code": "21651",
"telephone_number": "410-778-0088",
"fax_number": "410-778-9592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 S CROSS ST",
"address_2": "SUITE 1",
"city": "CHESTERTOWN",
"state": "MD",
"postal_code": "216204752",
"telephone_number": "410-778-0088",
"fax_number": "410-778-9592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "PAUL",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2008-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "MD",
"license": "D0052487",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MD",
"license": "D0052487",
"primary": true
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "MD",
"license": "D0052487",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chestertown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.