Joel David Johnson, M.D.

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

G7829 Issued in TX

Practice address

618 S Broadway Ave
Tyler, TX 75701-1665

Phone

(903) 596-9900

Fax

(903) 596-0242

NPI assigned

Aug 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment NPD
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD
• Smith Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Tyler, TX
  • NPI 1861426041
  NPD (past)
• Trinity Clinic

  dba Trinity Clinic Family Practice

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1922058304
  NPD (past)

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1922090497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011665",
            "telephone_number": "903-596-9900",
            "fax_number": "903-596-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011665",
            "telephone_number": "903-596-9900",
            "fax_number": "903-596-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "G7829",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "G7829",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079835701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guerda Johnson, NP
• Janet Johnson
• Janice Johnson, RNC, BSN
• Jason Bradley Johnson, NP-C
• Jessica D Johnson
• Jordan Lee Johnson
• Juanita Ruth Johnson, LNFA
• Karen Wells Johnson, M.A., CCC-SLP
• Kathryn Hope Johnson
• Kesila Johnson

• Critical Care Medicine (Internal Medicine) Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Critical Care Medicine (Internal Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.