Individual provider Active NPI

Dale B Johnson, M.D.

  • Diagnostic Radiology Physician
  • Clinton, MD
National Provider Identifier
1982690103
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D0055117 Issued in MD
Practice address
7501 Surratts Rd
Clinton, MD 20735-3362
Phone
(301) 870-7001
Fax
(301) 870-6697
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X D0055117 MD Primary

Addresses

Primary practice location

7501 Surratts Rd
Clinton, MD 20735-3362

Mailing address

7503 Surratts Rd
Clinton, MD 20735-3358
Phone (301) 870-7001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, IL, MO3 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
I20040319000707 MD Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 3173413408 Reassigns benefits to 4 organizations
I20231018000206 IL Practitioner - Diagnostic Radiology 3173413408 Reassigns benefits to 2 organizations
I20240116001866 MO Practitioner - Diagnostic Radiology 3173413408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Yale University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialists in Medical Imaging SCGroup PAC ID 2163733544, 228 clinicians
Blessing HospitalGroup PAC ID 3072422534, 414 clinicians
University of Maryland Community Medical Group IncGroup PAC ID 3678472214, 446 clinicians

Practice addresses (Care Compare)

Grasonville, MD 21638
Phone (309) 671-8282

100 Medical Dr
Hannibal, MO 63401-6877
Phone (217) 223-8400

1005 Broadway St
Quincy, IL 62301-2834
Phone (309) 671-8282

219 S Washington St
Easton, MD 21601-2913
Phone 41082210005845

927 Broadway St
Quincy, IL 62301-2719
Phone (217) 224-6423

Hospital & facility affiliations

  • Blessing Hospital Hospital, Quincy, IL, CCN 140015
  • University of MD Shore Medical Center at Easton Hospital, Easton, MD, CCN 210037
  • Illini Community Hospital Hospital, Pittsfield, IL, CCN 141315
  • Pike County Memorial Hospital Hospital, Louisiana, MO, CCN 261333
  • University of MD Shore Medical Ctr at Chestertown Hospital, Chestertown, MD, CCN 210030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0055117MDMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Community Medical Group, Inc. CurrentSince Oct 25, 2023 Accepting new patients
West Central Pathology Specialists, S.C. Current Accepting new patients
Quincy Clinical Laboratory Services SC Current Accepting new patients
Delmarva Radiology P.a. Diagnostic Radiology CurrentSince Aug 18, 2014 Accepting new patients
Specialists in Medical Imaging, SC Diagnostic Radiology CurrentSince Dec 28, 2024 Accepting new patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
Blessing Hospital CurrentSince Oct 7, 2023 Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Aug 14, 2023 Accepting new patients
Blessing Hospital CurrentSince Oct 7, 2023 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Oct 25, 2023 Accepting new patients
Southern Maryland Professional Rad Diagnostic Radiology Past Accepting new patients
DRS Groover Christie & Merritt PC Diagnostic Radiology Past Accepting new patients
Southern Radiology MRI Partnership Diagnostic Radiology Past Accepting new patients

Locations

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

4800 Maine St
Quincy, IL 62305
Phone (217) 214-0444

1005 Broadway St
Quincy, IL 62301

2435 W Belvedere Ave
Ste 4
Baltimore, MD 21215
Phone (410) 601-5547

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

219 S Washington St
Easton, MD 21601

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

918 Eastern Shore Dr
Salisbury, MD 21804
Phone (410) 749-1123

101 Medical Dr
Hannibal, MO 63401

100 Medical Dr
Hannibal, MO 63401

103 E Commercial St
Kahoka, MO 63445
Phone (660) 727-3377

Interoperability endpoints

  • Direct secure messaging: djohnson483381@direct.umm.edu
  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 8

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212105600000",
    "number": "1982690103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7503 SURRATTS RD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353358",
            "telephone_number": "301-870-7001",
            "fax_number": "301-870-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 SURRATTS RD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353362",
            "telephone_number": "301-870-7001",
            "fax_number": "301-870-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DALE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2008-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0055117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

Verify at the official NPI Registry.