Individual provider Active NPI

Scott Hazlehurst Johnson, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Grand Blanc, MI
National Provider Identifier
1962500900
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
4301087166 Issued in MI
Practice address
1 Genesys Pkwy Ste 3452
Grand Blanc, MI 48439-8065
Phone
(248) 849-2600
Fax
(248) 849-2610
NPI assigned
Sep 21, 2006
Last updated
Jul 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 36390 SC
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 4301087166 MI Primary

Addresses

Primary practice location

1 Genesys Pkwy Ste 3452
Grand Blanc, MI 48439-8065

Mailing address

16001 W 9 Mile Rd # 3
Southfield, MI 48075-4818
Phone (248) 849-2600

Other practice location 1

890 W Faris Rd
Suite 550
Greenville, SC 29605-4253
Phone (864) 455-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, SC, GA3 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
I20060420000199 MI Practitioner - Thoracic SurgeryPractitioner - General Surgery 1557308822 Reassigns benefits to 1 organization
I20140110001458 SC Practitioner - Cardiac SurgeryPractitioner - Thoracic Surgery 1557308822 Reassigns benefits to 2 organizations
I20220829003002 GA Practitioner - Cardiac SurgeryPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Thoracic Surgery 1557308822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Cardiovascular Disease (Cardiology), Thoracic Surgery
Education
Duke University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoebe Physician Group IncGroup PAC ID 8426112350, 420 clinicians

Practice addresses (Care Compare)

425 W 3Rd Ave
Suite 510
Albany, GA 31701-1959
Phone (229) 312-5133

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36390SCMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesys Practice Partners Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Aug 1, 2021 Accepting new patients
Musc Community Physicians CurrentSince May 12, 2022 Accepting new patients
Genesys Practice Partners, Inc CurrentSince Aug 1, 2021 Accepting new patients
Phoebe Physician Group, Inc CurrentSince Jul 1, 2022 Accepting new patients
Greenville Health System CurrentSince Nov 25, 2013 Accepting new patients
Musc Community Physicians Current Accepting new patients
Genesys Practice Partners Inc Current Accepting new patients
Musc Community Physicians CurrentSince May 12, 2022 Accepting new patients
Cardiac Surgery Associates SC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Genesys Practice Partners Inc Past Accepting new patients
Mercy Clinic Cardiovascular and Thoracic Surgery, LLC Past Accepting new patients
Phoebe Putney Memorial Hospital Inc Past Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

425 W 3rd Ave
Ste 510
Albany, GA 31701
Phone (229) 312-7500

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

1460 N Center Rd
Burton, MI 48509
Phone (810) 424-2011

1 Genesys Pkwy
Ste 3452
Grand Blanc, MI 48439
Phone (248) 849-2600

1400 Genesys Pkwy
#B136
Grand Blanc, MI 48439
Phone (810) 606-7629

3399 Pollock Rd
Ste A
Grand Blanc, MI 48439
Phone (810) 606-7550

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

805 Pamplico Hwy
Florence, SC 29505
Phone (843) 674-2500

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

Interoperability endpoints

  • Direct secure messaging: scott.johnson.1@8478.direct.athenahealth.com
  • Direct secure messaging: scott.johnson@phoebehealth.gadirect.net

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

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1962500900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD # 3",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-2600",
            "fax_number": "248-849-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY STE 3452",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "248-849-2600",
            "fax_number": "248-849-2610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "890 W Faris Rd",
            "address_2": "Suite 550",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054253",
            "country_code": "US",
            "telephone_number": "864-455-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SCOTT",
        "middle_name": "HAZLEHURST",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "SC",
            "license": "36390",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MI",
            "license": "4301087166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.