Individual provider Active NPI

Suzanne M. Johnson

  • Family Medicine Physician
  • Sarasota, FL
National Provider Identifier
1912944984
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35068401 Issued in OH
Practice address
5309 Fruitville Rd
Sarasota, FL 34232-6402
Phone
(941) 909-7847
Fax
(844) 388-6186
NPI assigned
May 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35068401 OH Primary
General Practice Physician 208D00000X 35.068401 OH

Addresses

Primary practice location

5309 Fruitville Rd
Sarasota, FL 34232-6402

Mailing address

5309 Fruitville Rd
Sarasota, FL 34232-6402
Phone (941) 909-7847

Other identifiers 1

IdentifierTypeStateIssuer
0155602MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, FL, CO3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20100406000339 OH Practitioner - Family Practice 1153359864 Reassigns benefits to 1 organization
I20190618000513 FL Practitioner - General Practice 1153359864 Reassigns benefits to 2 organizations
I20240328001081 CO Practitioner - Family PracticePractitioner - General Practice 1153359864 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35068401OHMDFamily Medicine Physician
35.068401OHMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Associates LLC CurrentSince Aug 1, 2019 Accepting new patients
Signify Health Medical Associates of Colorado, PLLC. General Practice CurrentSince Mar 15, 2024 Accepting new patients
Signify Health, LLC General Practice CurrentSince Oct 31, 2023 Accepting new patients

Locations

7900 E Union Ave
Ste 1100
Denver, CO 80237
Phone (469) 466-7420

13940 N US Highway 441
Ste 102
Lady Lake, FL 32159
Phone (352) 509-9900

2955 SE 3rd Ct
Ste B
Ocala, FL 34471
Phone (352) 509-9900

3920 Bee Ridge Rd
Ste H
Sarasota, FL 34233
Phone (941) 926-8855

5309 Fruitville Rd
Sarasota, FL 34232
Phone (941) 909-7847

601 S Harbour Island Blvd
Ste 200
Tampa, FL 33602
Phone (727) 322-3439

175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1912944984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5309 FRUITVILLE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326402",
            "telephone_number": "941-909-7847",
            "fax_number": "844-388-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5309 FRUITVILLE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326402",
            "telephone_number": "941-909-7847",
            "fax_number": "844-388-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SUZANNE",
        "middle_name": "M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2021-10-08",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35068401",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "35.068401",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0155602",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.