NPIMap

Individual provider Active NPI

Douglas J Johnson, M.D.

  • Family Medicine Physician
  • Bowling Green, KY
National Provider Identifier
1982671855
Registry record updated Jun 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
29380 Issued in KY
Practice address
1777 Ashley Cir
Bowling Green, KY 42104-3339
Phone
(270) 781-4090
Fax
(270) 842-3133
NPI assigned
Mar 1, 2006
Last updated
Jun 30, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 29380 KY
Family Medicine Physician 207Q00000X 29380 KY Primary

Addresses

Primary practice location

1777 Ashley Cir
Bowling Green, KY 42104-3339

Mailing address

1777 Ashley Cir
Bowling Green, KY 42104-3339
Phone (270) 781-4090

Other identifiers 3

IdentifierTypeStateIssuer
000000259189OtherKYANTHEM BC & BS
64293806MedicaidKY
50002852MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100408000527 KY Practitioner - Family Practice 9638205156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Washington University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

427 US 31W Byp
Bowling Green, KY 42101-1703
Phone (270) 796-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.83 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
82.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29380KYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Health Corporation, Inc. CurrentSince Sep 7, 2024 Accepting new patients
Commonwealth Health Corporation, Inc Current Accepting new patients
Commonwealth Health Corporation, Inc. Family Medicine CurrentSince Sep 7, 2024 Accepting new patients
Commonwealth Health Corporation Family Medicine Past Accepting new patients

Locations

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

350 Park St
Ste 203
Bowling Green, KY 42101
Phone (270) 781-0075

427 US 31W Byp
Bowling Green, KY 42101
Phone (270) 796-8000

Organizations & group practices 4

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 7

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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1982671855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 ASHLEY CIR",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043339",
            "telephone_number": "270-781-4090",
            "fax_number": "270-842-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 ASHLEY CIR",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043339",
            "telephone_number": "270-781-4090",
            "fax_number": "270-842-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DOUGLAS",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "29380",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "29380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC & BS",
            "identifier": "000000259189",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64293806",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50002852",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.