DR. SAMUEL O JOHNSON (NPI# 1457394165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457394165 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL O JOHNSON |
| Credential | MD |
| Practice Address |
109 Ambulance Drive Carrollton GA 30117-3855 |
| Practice Telephone | 7702141335 |
| Practice Fax Number | 7702141332 |
| Mailing Telephone | 7702141335 |
| Mailing Fax Number | 7702141332 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2009-03-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
026137 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000531319O | 05 | |
| GA | BLUE CROSS | 52486217003 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780176677 | Samuel Eric Johnson | Dentist | 5128 Old Highway 11 Ste 7, Hattiesburg, MS 39402-6234 | 2018-06-05 |
| 1245730787 | Samuel Johnson | Behavior Technician | 17688 71st Ln N, Loxahatchee, FL 33470-5501 | 2018-02-20 |
| 1902357874 | Samuel Alexander Johnson | Counselor | 16755 Hughes Rd, Victorville, CA 92395-4563 | 2016-10-17 |
| 1184095556 | Samuel Lee Johnson IIi | Counselor | 2100 Woodmere Blvd Ste 135, Harvey, LA 70058-2294 | 2015-10-12 |
| 1558740803 | Samuel Johnson | Physician Assistant | 2901 Metro Drive, Suite 527, Bloomington, MN 55122 | 2015-05-20 |
| 1487032751 | Samuel H Johnson | Social Worker | 500 Adams Street, Box 3243, Seward, AK 99664-3243 | 2015-05-07 |
| 1285034496 | Samuel Johnson II | Specialist/Technologist | 220 Champions Drive, Harrisonburg, VA 22807-2478 | 2014-08-26 |
| 1528475092 | Samuel Johnson | Specialist/Technologist | 101 Womens Bldg, Oregon State University, Corvallis, OR 97331-8577 | 2014-07-16 |
| 1306111729 | Samuel Johnson | Counselor | 201 Humiston Cir, Thomaston, CT 06787-1223 | 2012-03-19 |
| 1205074846 | Samuel Charles-prabhakar Johnson | Physical Therapist | 1026 46th St, Brooklyn, NY 11219-2401 | 2009-02-03 |
| Street Address |
109 AMBULANCE DRIVE |
| City | CARROLLTON |
| State | GA |
| Zip Code | 30117-3855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
| 1093361404 | Eyedeal Eyecare LLC | Optometrist | 1735 S Us 27, Carrollton, GA 30117 | 2019-08-12 |
| 1710412473 | Janis James | Optometrist | 1735 S, Us-27, Walmart Vision Center, Carrollton, GA 30117 | 2017-05-01 |
| 1568881951 | Omar Hajmurad | Anesthesiology | 812 S Park St Ste 5, Carrollton, GA 30117 | 2014-04-14 |
| 1134550353 | Goodbodys Minor Med Express Care | Nurse Practitioner | 1670 South Park St., Carrollton, GA 30117 | 2013-12-13 |
| 1306187570 | Myriam C Vela-ortiz | Internal Medicine | 157 Clinic Ave Ste 203, Carrollton, GA 30117 | 2013-03-12 |
| 1891030201 | Air Evac Ems, Inc. | Ambulance | 827 Old Bremen Rd, Carrollton, GA 30117 | 2012-12-11 |
| 1952682486 | Angelic Wings Transport, Inc. | Non-emergency Medical Transport (VAN) | 362 B Columbia Drive, Carrollton, GA 30117 | 2011-08-29 |
| 1073819256 | Atlanta Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 812 South Park Street, Suite 2, Carrollton, GA 30117 | 2011-02-04 |
| 1255640348 | Amy Gilbert | Counselor | 515 Tanner St, Carrollton, GA 30117 | 2010-10-06 |
| Find all providers in zip 30117 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083644199 | Richard B Colditz | Obstetrics & Gynecology | 150 Henry Burson Dr., Ste. # 215, Carrollton, GA 30117 | 2006-07-04 |
| 1891796587 | Mary Ann Franken | Obstetrics & Gynecology | 4323 N Josey Lane, Suite 306, Carrollton, TX 75010-4633 | 2005-08-03 |
| 1194093872 | Manik U Vora Md Pa | Obstetrics & Gynecology | 4333 N Josey Ln, Suite 101, Carrollton, TX 75010-4629 | 2011-12-08 |
| 1023301660 | Amy Reed Goss | Obstetrics & Gynecology | 109 Professional Pl, Carrollton, GA 30117-3862 | 2011-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558998070 | Gynecology Associates of Georgia | Obstetrics & Gynecology | 101 St Josephs Candler Dr Ste 300, Pooler, GA 31322-9588 | 2020-03-25 |
| 1295360949 | Premier Women's Gyn, LLC | Obstetrics & Gynecology | 101 Yorktown Dr Ste 224, Fayetteville, GA 30214-1578 | 2020-03-03 |
| 1073074175 | Mobile Md, LLC | Obstetrics & Gynecology | 746 Royal Springs Ln, Grovetown, GA 30813-4534 | 2019-03-29 |
| 1528565785 | Schilling Cosmetic Surgery & Aesthetics, LLC | Obstetrics & Gynecology | 1757 Rock Quarry Rd Ste A, Stockbridge, GA 30281-7303 | 2018-04-12 |
| 1356870547 | Her Wellness Center, LLC | Obstetrics & Gynecology | 1763 Highway 196 W, Hinesville, GA 31313-8013 | 2017-06-09 |
| 1245769777 | Better Health Better Life LLC | Obstetrics & Gynecology | 2398 Mount Vernon Rd Ste 150, Dunwoody, GA 30338-3064 | 2017-06-08 |
| 1699115451 | Jeffrey Alan Bernstein | Obstetrics & Gynecology | 655 Widgeon Lane, Atlanta, GA 30327 | 2013-06-26 |
| 1376899179 | Earl Edwin Sands | Obstetrics & Gynecology | 2200 Blackheath Trce, Alpharetta, GA 30005-6978 | 2012-07-30 |
| 1063788784 | Joseph Rudolph Prine Sr. | Obstetrics & Gynecology | 1216 Chennault Dr, Dublin, GA 31021-3006 | 2012-03-27 |
| 1871865113 | Candace Marvenia Tillman | Obstetrics & Gynecology | 477 Windsor St. Sw, Ste. 309, Atlanta, GA 30312 | 2012-02-02 |
| Find all providers with the same taxonomy | ||||
| City | CARROLLTON |
| Zip Code | 30117 |
Please comment or provide details below to improve the information on DR. SAMUEL O JOHNSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.