DR. JEREMY CLYDE JOHNSON


Address: 214 18th St Se, Hickory, NC 28602-1363
Phone: 7043232000

DR. JEREMY CLYDE JOHNSON (NPI# 1700823085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1700823085
Entity Type Individual
Full Name DR. JEREMY CLYDE JOHNSON
Credential M.D.
Practice Address 214 18th St Se
Hickory
NC 28602-1363
Mailing Address 4601 Park Rd
Suite 300
Charlotte
NC 28209-3239
Practice Telephone 7043232000
Mailing Telephone 7043232000
Enumeration Date 2006-06-02
Last Update Date 2012-04-13
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207X00000X Orthopaedic Surgery 9901552 NC Allopathic & Osteopathic Physicians
Y 207XX0005X Orthopaedic Surgery
Specialization: Sports Medicine
9901552 NC Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NC DEA NUMBER BJ6637295 01
NC 89137X6 05

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1194368779 Jeremy Paul Johnson Acupuncturist 1500 W Farwell Ave Apt 3, Chicago, IL 60626-3666 2019-10-25
1457838922 Jeremy Braxton Johnson Dietitian, Registered 283 Walnut St, Baxley, GA 31513-0954 2018-07-26
1306384524 Jeremy Johnson Physical Therapy Assistant 653 Golden Trl, Cave City, AR 72521-9432 2017-02-08
1992186530 Jeremy Johnson Student in an Organized Health Care Education/Training Program 1141 154th Ave Ne, Mayville, ND 58257 2015-06-09
1801274550 Jeremy Tate Johnson Specialist/Technologist 1637 Perryville Rd., Boyle County High School, Danville, KY 40422 2015-05-14
1811374549 Jeremy V Johnson Family Medicine 500b Jefferson Blvd Ste 180, West Sacramento, CA 95605-2394 2015-05-01
1902200660 Jeremy Johnson Counselor 1022 N Prospect St, Bowling Green, OH 43402-1335 2014-10-09

Office Location

Street Address 214 18TH ST SE
City HICKORY
State NC
Zip Code 28602-1363

Providers in the same location

NPI Name Taxonomy Address Enumeration
1144293143 Russell V Gilchrist Physical Medicine & Rehabilitation 214 18th St Se, Hickory, NC 28602-1363 2006-02-09
1023573771 Lacy Peterson Physical Therapist 214 18th St Se, Hickory, NC 28602-1363 2019-02-07
1770047102 Hannah Hodge Physician Assistant 214 18th St Se, Hickory, NC 28602-1363 2019-01-30
1598288631 Claire Elizabeth Bingham Physical Therapist 214 18th St Se, Hickory, NC 28602-1363 2017-07-20
1679010904 Kyle Fox Physician Assistant 214 18th St Se, Hickory, NC 28602-1363 2017-01-25
1215484613 Kathryn Jones Nurse Practitioner 214 18th St Se, Hickory, NC 28602-1363 2016-09-02
1740655257 Randall Stepp Specialist/Technologist 214 18th St Se, Hickory, NC 28602-1363 2015-12-09
1225380033 Anthony Albert Mirovsky II Physical Therapist 214 18th St Se, Hickory, NC 28602-1363 2012-10-04
1932454469 Dalan D Garcia Physician Assistant 214 18th St Se, Hickory, NC 28602-1363 2012-07-20
1346518073 Orthocarolina, Pa Orthopaedic Surgery 214 18th St Se, Hickory, NC 28602-1363 2011-12-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1063983286 Ivan Ortega Health Educator 810 Fairgrove Church Road Se, Hickory, NC 28602 2018-12-16
1578078895 Zachary Chad Greer Physician Assistant 1927 3rd Ave Ln Se, Hickory, NC 28602 2017-12-08
1952842015 Eyemart Express LLC Eyewear Supplier (Equipment, not the service) 2264 Us Highway 70 Se, Hickory, NC 28602 2017-03-09
1013456318 Juanita Brown Counselor 306 4th St Sw, Hickory, NC 28602 2017-02-20
1639616725 Francisca Blanco Clinic/Center 5276 0lde School Dr, Hickory, NC 28602 2017-01-26
1982155263 Livanta Medical Center Physician Assistant 2105 Catawba Valley Blvd Se, Hickory, NC 28602 2016-10-20
1225588817 Melike Demirozu Social Worker 738 4th St. Sw, Hickory, NC 28602 2016-10-07
1528411592 April Prout Social Worker 1053 13th St Se, Hickory, NC 28602 2016-07-14
1457706921 Maitry Parikh Dentist 2535 Us Highway 70 Se Ste 112, Hickory, NC 28602 2016-05-03
1245614510 Doran Stilwell Physical Therapy Assistant 4161 South Fork Avenue, Hickory, NC 28602 2015-07-16
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Taxonomy Information

Taxonomy Code 207XX0005X
Grouping Allopathic & Osteopathic Physicians
Classification Orthopaedic Surgery
Specialization Sports Medicine

Taxonomy Definition

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1902241805 Ian Al'khafaji Orthopaedic Surgery 2719 Reynolda Rd, Winston Salem, NC 27106 2013-05-06
1821354812 Sunny Patel Orthopaedic Surgery 1234 Huffman Mill Rd Dept Of, Burlington, NC 27215 2012-04-04
1174763981 Brett Andrew Fritsch Orthopaedic Surgery Duke Sports Medicine Ctr, 300 Frank Bassett Drive, Durham, NC 27710-0001 2009-03-06
1033366885 Scotland Orthopedics, Pa Orthopaedic Surgery 410 D South Jones Street, Pembroke, NC 28372 2008-08-23
1437315165 North Carolina Shoulder and Elbow Surgery and Sports Medicine Orthopaedic Surgery 900 North Howe St, Southport, NC 28461 2008-08-01
1750542411 Abby B. Maxwell Orthopaedic Surgery 3 Mcdowell St, Suite B, Asheville, NC 28801-4103 2008-06-24
1518130418 Jeffrey Tweed Spang Orthopaedic Surgery University of North Carolina Hospital, Cb# 7055, Chapel Hill, NC 27599-7055 2008-04-11
1184746810 Kevin Leo Krasinski Orthopaedic Surgery 1236 Huffman Mill Rd Ste 1300, Burlington, NC 27215-8700 2007-04-04
1285748970 Statesville Hma Physician Management, Inc Orthopaedic Surgery 340 Signal Hill Dr, Suite A, Statesville, NC 28625-4357 2006-08-18
1467461566 Timothy Ned Taft Orthopaedic Surgery 3154 Bioinformatics Bldg, Cb # 7055 Unc, Chapel Hill, NC 27599-0001 2006-08-07
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Competitor

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City HICKORY
Zip Code 28602

Improve Information

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Dataset Information

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.

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