Individual provider Active NPI

Paul Johnson, M.D.

  • Colon & Rectal Surgery Physician
  • Memphis, TN
National Provider Identifier
1992062855
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
64847 Issued in TN
Practice address
1265 Union Avenue, 2 Shorb Tower
Memphis, TN 38104-2030
Phone
(901) 478-0900
Fax
(901) 266-6415
NPI assigned
Apr 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME138979 FL
Surgery Physician 208600000X 64847 TN
Colon & Rectal Surgery Physician 208C00000X ME138979 FL
Colon & Rectal Surgery Physician 208C00000X 64847 TN Primary

Addresses

Primary practice location

1265 Union Avenue, 2 Shorb Tower
Memphis, TN 38104-2030

Mailing address

1211 Union Ave Ste 330
Memphis, TN 38104-6655
Phone (901) 478-0954

Other practice location 1

1425 Malabar Rd NE
Palm Bay, FL 32907-2506
Phone (321) 434-8078

Other practice location 2

7705 Poplar Ave Ste 220
Germantown, TN 38138-3930
Phone (901) 516-6792

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
I20220301001844 TN Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 7012246408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Meharry Medical College School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Methodist Physicians LLCGroup PAC ID 2769623669, 123 clinicians

Practice addresses (Care Compare)

1265 Union Ave
Memphis, TN 38104-3415
Phone (901) 478-2211

Hospital & facility affiliations

  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy22
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Methodist Physicians LLC Surgery CurrentSince Mar 14, 2022 Accepting new patients

Locations

1325 Eastmoreland Ave
Ste 370
Memphis, TN 38104
Phone (901) 516-8785

1265 Union Ave
#2
Memphis, TN 38104
Phone (901) 478-2211

7705 Poplar Ave
Ste 220
Memphis, TN 38138
Phone (901) 516-6792

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

Interoperability endpoints

  • Direct secure messaging: pjohnson31715@mlh.direct-ci.com
  • Direct secure messaging: pjohnson517518@direct.bmhcc.org

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.

Hospital & facility affiliations 3

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": "1334620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1992062855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655",
            "telephone_number": "901-478-0954",
            "fax_number": "901-478-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 UNION AVENUE, 2 SHORB TOWER",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042030",
            "telephone_number": "901-478-0900",
            "fax_number": "901-266-6415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 Malabar Rd NE",
            "address_purpose": "LOCATION",
            "city": "Palm Bay",
            "state": "FL",
            "postal_code": "329072506",
            "country_code": "US",
            "telephone_number": "321-434-8078",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7705 Poplar Ave Ste 220",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383930",
            "country_code": "US",
            "telephone_number": "901-516-6792",
            "fax_number": "901-266-6459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-17",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME138979",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "64847",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "ME138979",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "TN",
            "license": "64847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.