Individual provider Active NPI

Jason Nathaniel Johnson, M.D.

  • Pediatrics Physician
  • Memphis, TN
National Provider Identifier
1982870119
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
134548 Issued in NC
Practice address
848 Adams Ave
L400
Memphis, TN 38103-2816
Phone
(919) 684-8111
NPI assigned
May 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 134548 NC Primary

Addresses

Primary practice location

848 Adams Ave
L400
Memphis, TN 38103-2816

Mailing address

848 Adams Ave
L400
Memphis, TN 38103-2816
Phone (919) 684-8111

Other identifiers 1

IdentifierTypeStateIssuer
134548OtherNCMEDICAL LISCENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130626000683 TN Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 6608015920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Lebonheur Pediatric Specialists, Inc.Group PAC ID 7719173939, 162 clinicians

Practice addresses (Care Compare)

100 N Humphreys Blvd
Memphis, TN 38120-2146
Phone (901) 287-7337

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49957TNMDLicensed Practical Nurse
134548NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Lebonheur Pediatric Specialists, Inc. Pediatrics CurrentSince Jul 1, 2013 Accepting new patients

Locations

850 Poplar Ave
Bldg 2
Memphis, TN 38105
Phone (901) 287-5594

100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800

848 Adams Ave
#L400
Memphis, TN 38103
Phone (901) 287-5207

1407 Union Ave
Ste 200
Memphis, TN 38104
Phone (901) 866-8360

Interoperability endpoints

  • Direct secure messaging: jjohnson27372@mlh.direct-ci.com

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": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1982870119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "848 ADAMS AVE",
            "address_2": "L400",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032816",
            "telephone_number": "919-684-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 ADAMS AVE",
            "address_2": "L400",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032816",
            "telephone_number": "919-684-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JASON",
        "middle_name": "NATHANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "134548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LISCENSE NUMBER",
            "identifier": "134548",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.