DR. EDWARD WALLACE JOHNSON III (NPI# 1285073890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285073890 |
| Entity Type | Individual |
| Full Name | DR. EDWARD WALLACE JOHNSON III |
| Credential | M.D. |
| Practice Address |
1505 State Highway 19 S Athens TX 75751-8950 |
| Mailing Address |
Po Box 846098 Dallas TX 75284-6098 |
| Practice Telephone | 9036751725 |
| Practice Fax Number | 9036754790 |
| Mailing Telephone | 9033246400 |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2017-01-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 23591 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TRICARE | 75-2616977-029 | 01 |
| TX | BCBS | 8GF799 | 01 |
| TX | 364829701 | 05 | |
| TX | RAIL ROAD MEDICARE | P01754632 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194385708 | Edward Robert Johnson | Behavior Technician | West 6th Avenue Suite 1000, Lakewood, CO 80215-8021 | 2019-06-17 |
| 1477097368 | Edward C Johnson | Counselor | 24020 Plank Rd, Zachary, LA 70791-6429 | 2016-12-12 |
| 1245630375 | Edward Damon Johnson | Counselor | 1833 Marcia Dr, Orlando, FL 32807-6355 | 2014-08-26 |
| 1447592951 | Edward Arthur Johnson | Dentist | 841 S Dora St, Ukiah, CA 95482-5710 | 2013-03-22 |
| 1225394554 | Edward Merle Johnson II | Pharmacist | 100 Pier 1 Pl Ste 2001, Fort Worth, TX 76102 | 2012-04-11 |
| 1902079015 | Edward Alex Johnson | Pediatrics | 811 Redgate Ave, Norfolk, VA 23507-1515 | 2008-04-09 |
| 1639388705 | Edward Francis Johnson Jr. | Chiropractor | 14510 Lakeshore Dr, Clearlake, CA 95422 | 2007-05-22 |
| 1609093251 | Edward N. Johnson | Family Medicine | 308 Central Ave, Sault Sainte Marie, MI 49783-1102 | 2007-04-18 |
| 1487750964 | Edward L. Johnson | Dentist | 928 State Route 716, Ashland, KY 41102-9231 | 2006-09-15 |
| 1780691311 | Edward T. Johnson | Chiropractor | 600 John Sims Pkwy E, Niceville, FL 32578-2030 | 2006-08-03 |
| Street Address |
1505 STATE HIGHWAY 19 S |
| City | ATHENS |
| State | TX |
| Zip Code | 75751-8950 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124024765 | Terri Lynn Eckert | Family Medicine | 1505 State Highway 19 S, Athens, TX 75751-8950 | 2005-06-27 |
| 1265788285 | Rebecca A Powell | Nurse Practitioner | 1505 State Highway 19 S, Athens, TX 75751-8950 | 2012-07-27 |
| 1760458400 | Stephanie Michelle West | Family Medicine | 1505 State Highway 19 S, Athens, TX 75751-8950 | 2006-02-23 |
| 1508831942 | J Elaine Shaw | Pediatrics | 1505 State Highway 19 S, Athens, TX 75751-8950 | 2006-02-21 |
| 1346214624 | Steven Helf | Internal Medicine | 1505 State Highway 19 S, Athens, TX 75751-8950 | 2006-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700414810 | Morghan Jungman | Physical Therapy Assistant | 6444 South Palestine St, Athens, TX 75751 | 2020-04-01 |
| 1497313340 | Rebecca Lynne Moehlenbrock | Physical Therapy Assistant | 711 Lucas Dr., Athens, TX 75751 | 2019-06-04 |
| 1013487669 | Jammie Jae Chaney | Licensed Vocational Nurse | 207 Colonial Circle, Athens, TX 75751 | 2018-11-27 |
| 1215423397 | Valarie M Chambless | Registered Nurse | 1505 Hwy. 19 South, Athens, TX 75751 | 2018-07-02 |
| 1609378181 | Jennifer Lynn Griffith | Occupational Therapist | 907 S Palenstine St., Athens, TX 75751 | 2018-03-01 |
| 1285931832 | Leonard J Barbarisi | Surgery | 6444 S Palestine, Athens, TX 75751 | 2011-02-17 |
| 1801123104 | Paul J Michiels | Family Medicine | 5313 Fm 2494, Athens, TX 75751 | 2009-11-06 |
| 1851527550 | Jordan Risinger | Dentist | 800 S. Palestine St., Athens, TX 75751 | 2009-06-08 |
| 1306005798 | Shawn Tai | Internal Medicine | 115 Medical Cir Ste 106, Athens, TX 75751 | 2008-06-02 |
| 1083730683 | Assisted Living Concepts Inc | Assisted Living Facility | 213 Cayuga Drive, Athens, TX 75751 | 2007-03-22 |
| Find all providers in zip 75751 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164023529 | Aderholt Medical, LLC | Family Medicine | 320 Old Us-31 N, Athens, AL 35611 | 2020-11-03 |
| 1497371496 | Summit Medical Group, Pllc | Family Medicine | 1031 W Madison Ave Ste 1, Athens, TN 37303-3496 | 2020-06-25 |
| 1821558305 | Physician Management Services of Georgia II, LLC | Family Medicine | 1010 Prince Ave Ste 183, Athens, GA 30606-5805 | 2019-03-21 |
| 1649777152 | Ohio University | Family Medicine | 1 Ohio University Fl 5, Athens, OH 45701-2942 | 2018-04-11 |
| 1508392267 | Boulevard Family Practice | Family Medicine | 1010 Prince Ave Ste 184, Athens, GA 30606-5815 | 2017-05-02 |
| 1225585391 | Advantage Health Solutions,llc | Family Medicine | 707 West Market St Ste A, Athens, AL 35611 | 2016-09-07 |
| 1356736417 | Brett Magner | Family Medicine | 855 W Broad St Ste 1, Athens, GA 30601 | 2015-04-05 |
| 1538580121 | Oconee Weight and Wellness, LLC | Family Medicine | 455 Epps Bridge Pkwy Ste 102, Athens, GA 30606-3347 | 2013-12-27 |
| 1306110150 | Charles Russell Fisher | Family Medicine | 86 Columbus Cir Ste 203, Athens, OH 45701-1371 | 2012-02-25 |
| 1801123104 | Paul J Michiels | Family Medicine | 5313 Fm 2494, Athens, TX 75751 | 2009-11-06 |
| Find all providers in ATHENS | ||||
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| 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.