Individual provider Active NPI

Sydney Yvonne Johnson, MD

  • Surgery Physician
  • Norfolk, VA
National Provider Identifier
1962934372
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101280803 Issued in VA
Practice address
601 Childrens LN
Norfolk, VA 23507-1910
Phone
(757) 668-7703
NPI assigned
Apr 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101280803 VA Primary

Addresses

Primary practice location

601 Childrens LN
Norfolk, VA 23507-1910

Mailing address

601 Childrens LN
Norfolk, VA 23507-1910

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101280803VAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Surgical Specialty Group, Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1962934372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 CHILDRENS LN",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CHILDRENS LN",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071910",
            "telephone_number": "757-668-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SYDNEY",
        "middle_name": "YVONNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101280803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.