DR. THEODORE SAMUEL JOHNSON


Address: 1120 Fifteenth Street, Cn-4141a, Augusta, GA 30912
Phone: 7067213626

DR. THEODORE SAMUEL JOHNSON (NPI# 1255453759) 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) 1255453759
Entity Type Individual
Full Name DR. THEODORE SAMUEL JOHNSON
Credential M.D., PH.D.
Practice Address 1120 Fifteenth Street, Cn-4141a
Augusta
GA 30912
Practice Telephone 7067213626
Practice Fax Number 7067214804
Mailing Telephone 7067213626
Mailing Fax Number 7067214804
Enumeration Date 2007-04-04
Last Update Date 2017-06-15
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080P0207X Pediatrics
Specialization: Pediatric Hematology-Oncology
64115 GA Allopathic & Osteopathic Physicians

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1972661494 Theodore Coatany Johnson Dentist 4855 Ward Rd, Suite 700, Wheat Ridge, CO 80033 2006-12-05
1326099227 Theodore Stanley Johnson Anesthesiology Dept. # 1029, Denver, CO 80263-0001 2006-05-15
1144606724 Theodore Johnson Behavioral Analyst 2300 W Sahara Ave, Suite 800, Las Vegas, NV 89102-4352 2015-08-05
1417000282 Theodore Leroy Johnson Audiologist 177 Franklin Corner Rd, Ste. 1b, Lawrenceville, NJ 08648-2548 2007-01-18
1356446777 Theodore Martin Johnson Psychologist 500 Lilly Rd Ne, #205, Olympia, WA 98506-5195 2006-09-13
1306953591 Theodore Lybarger Johnson Dentist 555 B Street, Springfield, OR 97477 2006-08-24
1265494983 Theodore Michael Johnson II Internal Medicine 1365 Clifton Rd Ne, Atlanta Va Medical Center, 508/11b, Atlanta, GA 30322-1013 2006-04-06

Office Location

Street Address 1120 FIFTEENTH STREET, CN-4141A
City AUGUSTA
State GA
Zip Code 30912

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548885940 Hannah Gullickson Folsom Family Medicine 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 2020-06-11
1487278909 Robert Kennedy Internal Medicine Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 2020-06-01
1952968737 Kayla M. Lasota Pediatrics 11230 115th St Ae3042, Augusta, GA 30912 2019-05-28
1003379280 Kayla Cox Internal Medicine 1120 15th St Bi5070, Augusta, GA 30912 2019-04-13
1619435740 Justin Ray Mackert Student in an Organized Health Care Education/Training Program Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 2019-03-07
1417444167 Victor Celis Dentist John Wesley Gilbert Dr, Augusta, GA 30912 2018-04-18
1487157921 Julie Ann Matsen Student in an Organized Health Care Education/Training Program 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 2018-03-12
1497287031 Luke Yuung-jier Chang Ophthalmology 1120 15th St # Ba2720, Augusta, GA 30912 2017-04-02
1821537622 Lashawn Kay Boone Nurse Practitioner 1445 Harper St, Augusta, GA 30912 2017-02-14
1134675564 Arnab Saha Internal Medicine 1120 15 Th St., Augusta, GA 30912 2016-08-26
Find all providers in zip 30912

Taxonomy Information

Taxonomy Code 2080P0207X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Hematology-Oncology

Taxonomy Definition

A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1376821173 Nnenna Rosemary Ukachi Badamosi Pediatrics 1120 15th St, Augusta, GA 30912-3609 2011-07-27
1700195039 Betty Sue Pace Pediatrics 1120 15th St, Augusta, GA 30912-0004 2010-10-05
1932359171 Claude Sportes Pediatrics 1120 15th St, Augusta, GA 30912-0004 2008-09-24
1689707507 Cindy Elizabeth Neunert Pediatrics 1120 15th St, Augusta, GA 30912-0004 2007-03-13
1104937184 Roger A Vega Pediatrics 1120 15th St, Augusta, GA 30912-0004 2006-08-31
1508975475 Beverly A Bell Pediatrics 1120 15th St, Augusta, GA 30912-0004 2006-08-30
1265541403 Afshin Ameri Pediatrics 1120 15th St, Augusta, GA 30912-0004 2006-08-30
1164531281 Colleen H. Mcdonough Pediatrics 1120 15th St, Augusta, GA 30912-0004 2006-08-30
1700995834 Kathleen M. Mckie Pediatrics 1120 15th St, Augusta, GA 30912-0004 2006-08-30
1356450373 David H. Munn Pediatrics 1120 15th St, Augusta, GA 30912-0004 2006-08-30
Find all providers in AUGUSTA

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City AUGUSTA
Zip Code 30912

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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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