Individual provider Active NPI

Joseph Eugene Johnston, M.D.

  • Family Medicine Physician
  • Mount Olive, MS
National Provider Identifier
1922002567
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
03605 Issued in MS
Practice address
603 S Main St
Mount Olive, MS 39119-8902
Phone
(601) 797-3405
Fax
(601) 797-9842
NPI assigned
Jun 10, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 03605 MS Primary

Addresses

Primary practice location

603 S Main St
Mount Olive, MS 39119-8902

Mailing address

PO Box 1107
Mount Olive, MS 39119-1107
Phone (601) 797-3405

Other identifiers 1

IdentifierTypeStateIssuer
00015543MedicaidMS

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

LicenseStateTypeSpecialty
03605MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covington County Hospital Past Accepting new patients
Green Tree Family Medical Clinic 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, 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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1922002567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1107",
            "city": "MOUNT OLIVE",
            "state": "MS",
            "postal_code": "391191107",
            "telephone_number": "601-797-3405",
            "fax_number": "601-797-9842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 S MAIN ST",
            "city": "MOUNT OLIVE",
            "state": "MS",
            "postal_code": "391198902",
            "telephone_number": "601-797-3405",
            "fax_number": "601-797-9842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "JOSEPH",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "03605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00015543",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Olive, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.