Active NPI
John Wesley Johnson
- Pediatrics Physician
- Lawrenceville, GA
National Provider Identifier
1972985356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 080871
- Practice address
- 595 Hurricane Shoald Rd NW
Suite 300
Lawrenceville, GA 30046 - Phone
- (770) 995-0823
- Fax
- (678) 252-2249
- NPI assigned
- Jun 23, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 080871 | GA | Primary |
Addresses
Primary practice location
595 Hurricane Shoald Rd NW
Suite 300
Lawrenceville, GA 30046
Mailing address
595 Hurricane Shoald Rd NW
Suite 300
Lawrenceville, GA 30046
Phone (770) 995-0823
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
| License | State | Type | Specialty |
|---|---|---|---|
| 080871 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gwinnett Pediatrics & Adolescent Medicine | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- john.johnson.1@14859.direct.athenahealth.com
- https://api.platform.athenahealth.com/14859/brand/1/csg/1/fhir/r4
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.
-
- Pediatrics Physician
- Lawrenceville, GA
- NPI 1003940909
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532908800000",
"number": "1972985356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "595 HURRICANE SHOALD RD NW",
"address_2": "SUITE 300",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "30046",
"telephone_number": "770-995-0823",
"fax_number": "678-252-2249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "595 HURRICANE SHOALD RD NW",
"address_2": "SUITE 300",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "30046",
"telephone_number": "770-995-0823",
"fax_number": "678-252-2249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JOHN",
"middle_name": "WESLEY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-23",
"last_updated": "2018-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "080871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.