Individual provider Active NPI

Nathan Merritt Johnson, M.D.

  • Dermatology Physician
  • Roanoke, VA
National Provider Identifier
1942731674
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0116030218 Issued in VA
Practice address
1 Riverside Cir Ste 300
Roanoke, VA 24016-4962
Phone
(540) 224-5170
NPI assigned
Mar 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X E-13799 AR
Dermatology Physician 207N00000X 0116030218 VA Primary

Addresses

Primary practice location

1 Riverside Cir Ste 300
Roanoke, VA 24016-4962

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5353

Other practice location 1

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, VA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20210722000596 AR Practitioner - Dermatology 3779856026 Reassigns benefits to 1 organization
I20241106000909 VA Practitioner - Dermatology 3779856026 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Virginia Tech Carilion School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians
Carilion Healthcare CorporationGroup PAC ID 5890607253, 540 clinicians

Practice addresses (Care Compare)

101 Elm Ave
Roanoke, VA 24013-2222
Phone (540) 224-4380

101 Elm Ave SE
FL 3
Roanoke, VA 24013-2222
Phone (540) 224-6780

1204 Franklin Rd SW
Roanoke, VA 24016-4606
Phone (540) 981-1439

150 Market Ridge LN
Daleville, VA 24083-3258
Phone (540) 966-0400

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128

6415 Peters Creek Rd
Roanoke, VA 24019-4021
Phone (703) 562-2110

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision80
Removal of skin lesions965
Removal of nail tissue1-10
Removal or shaving of skin growth43
Skin biopsy320

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Oct 7, 2024 Accepting new patients
Carilion Giles Community Hospital CurrentSince Oct 7, 2024 Accepting new patients
Carilion Healthcare Corporation CurrentSince Oct 7, 2024 Accepting new patients
Carilion Tazewell Community Hospital CurrentSince Oct 7, 2024 Accepting new patients
Carilion Franklin Memorial Hospital CurrentSince Oct 7, 2024 Accepting new patients
Carilion Medical Center CurrentSince Oct 7, 2024 Accepting new patients
Carilion Healthcare Corporation CurrentSince Oct 7, 2024 Accepting new patients
Advanced Dermatology & Skin Cancer Center, LLC CurrentSince Sep 1, 2021 Accepting new patients
Carilion Rockbridge Community Hospital CurrentSince Oct 7, 2024 Accepting new patients
Carilion Giles Community Hospital CurrentSince Oct 7, 2024 Accepting new patients
Carilion Franklin Memorial Hospital CurrentSince Oct 7, 2024 Accepting new patients
Carilion Medical Center Past Accepting new patients

Locations

701 NW McNelly Rd
Ste 11
Bentonville, AR 72712
Phone (479) 254-8563

1444 E Stearns St
Ste 11
Fayetteville, AR 72703
Phone (479) 718-7546

1 Health Cir
Lexington, VA 24450
Phone (540) 458-3300

159 Hartley Way
Pearisburg, VA 24134
Phone (540) 921-6000

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

1 Riverside Cir
Ste 300
Roanoke, VA 24016
Phone (540) 581-0180

1204 Franklin Rd SW
Roanoke, VA 24016
Phone (540) 345-6010

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

180 Floyd Ave
Rocky Mount, VA 24151
Phone (540) 483-5277

388 Ben Bolt Ave
Tazewell, VA 24651
Phone (276) 988-2506

Interoperability endpoints

  • Direct secure messaging: njohnson53328@direct.carilionclinic.org

Organizations & group practices 12

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1942731674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713",
            "telephone_number": "540-224-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RIVERSIDE CIR STE 300",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164962",
            "telephone_number": "540-224-5170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1906 Belleview Ave SE",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240141838",
            "country_code": "US",
            "telephone_number": "540-981-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NATHAN",
        "middle_name": "MERRITT",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AR",
            "license": "E-13799",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0116030218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.