Homer Thomas Johnson II, M.D.

Primary specialty

Pediatric Sleep Medicine PhysicianTaxonomy code 2080S0012X

License

2007001620 Issued in MO

Practice address

1475 Kisker Rd
Suite 200
Saint Charles, MO 63304-8781

Phone

(636) 498-7880

Fax

(636) 498-7889

NPI assigned

Mar 18, 2007

Last updated

Mar 14, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Sleep MedicineAlso: Family Practice

Education

University of Missouri, Columbia School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SSM Medical Group, Inc.

  dba SSM Health Medical Group

  • Multi-Specialty Clinic/Center
  • Fenton, MO
  • NPI 1700966207
  Medicare reassignment Care Compare group NPD
• SSM Health Care St Louis

  dba SSM Health St Clare Fenton

  • Emergency Medicine Physician
  • Fenton, MO
  • NPI 1275586174
  Medicare reassignment NPD
• SSM Depaul Medical Group, Inc.

  dba SSM Health Medical Group

  • Internal Medicine Physician
  • Maryland Heights, MO
  • NPI 1760456743

  Family Medicine

  NPD (past)
• St Louis University

  dba SLUCare Sight & Sound Center

  • Optician
  • Saint Louis, MO
  • NPI 1487869863
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• SSM Health Care St. Louis

  dba SSM Health St. Joseph Hospital - St. Charles

  • General Acute Care Hospital
  • Saint Charles, MO
  • NPI 1467521146
  Care Compare affiliation

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

{
    "created_epoch": "1174176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1932223898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 KISKER RD",
            "address_2": "SUITE 200",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633048781",
            "telephone_number": "636-498-7880",
            "fax_number": "636-498-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HOMER",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-18",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 97186",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "NO. 2007001620",
            "primary": false
        },
        {
            "code": "207QS1201X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sleep Medicine",
            "state": "MO",
            "license": "2007001620",
            "primary": false
        },
        {
            "code": "2080S0012X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sleep Medicine",
            "state": "MO",
            "license": "2007001620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205475809",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1475 Kisker Rd",
            "address_2": "Suite 200",
            "city": "Saint Charles",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633048781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hjohnson10252@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "hjohnson10252@direct-ehr-ssmhc.com",
            "address_1": "1475 Kisker Rd",
            "address_2": "Suite 200",
            "city": "Saint Charles",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633048781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Allana June Johnson
• Ashley Johnson, LPC
• Ashley Deone Johnson, PT, DPT
• Desiree Taylor Johnson
• Emily Johnson
• Kirsten Danielle Johnson, M.S., CF-SLP
• Mark Samuel Johnson, PA-C MT ASCP
• Matthew Edward Johnson, M.D.
• Melissa Jynelle Johnson, COTA/L
• Michael O Johnson, M.D.

• Pediatrics Physician in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.