Individual provider Active NPI

Rodney Marc Johnson, M.D.

  • Allergy & Immunology Physician
  • Dublin, GA
National Provider Identifier
1992828289
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
64841 Issued in GA
Practice address
229 Industrial Blvd
Dublin, GA 31021-2969
Phone
(478) 353-1058
Fax
(478) 238-0841
NPI assigned
Apr 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 64841 GA
Allergy & Immunology Physician 207K00000X 64841 GA Primary

Addresses

Primary practice location

229 Industrial Blvd
Dublin, GA 31021-2969

Mailing address

229 Industrial Blvd
Dublin, GA 31021-2969
Phone (478) 353-1058

Other identifiers 2

IdentifierTypeStateIssuer
202I032517OtherGAMEDICARE PTAN
003110844PMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20110809000896 GA Practitioner - Allergy/Immunology 4688843535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Medical College of Georgia School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middle Georgia Allergy and Asthma LLCGroup PAC ID 0547585432, 3 clinicians

Practice addresses (Care Compare)

229 Industrial Blvd
Dublin, GA 31021-2969
Phone (478) 353-1058

Hospital & facility affiliations

  • Fairview Park Hospital Hospital, Dublin, GA, CCN 110125

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Georgia Allergy and Asthma LLC Allergy & Immunology CurrentSince Jan 13, 2015 Accepting new patients

Locations

229 Industrial Blvd
Dublin, GA 31021
Phone (478) 353-1058

227 Industrial Blvd
Dublin, GA 31021
Phone (478) 272-8494

Interoperability endpoints

  • Direct secure messaging: middlegaallergy@middlegaallergy.kareodirect.com
  • Direct secure messaging: drrodneyjohnson@johnson043.powersoftmdsecure.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.

Hospital & facility affiliations 1

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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1992828289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 INDUSTRIAL BLVD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212969",
            "telephone_number": "478-353-1058",
            "fax_number": "478-238-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 INDUSTRIAL BLVD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212969",
            "telephone_number": "478-353-1058",
            "fax_number": "478-238-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RODNEY",
        "middle_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "64841",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "GA",
            "license": "64841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "202I032517",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003110844P",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, GA

Sources for this page

Verify at the official NPI Registry.