DR. EDWARD ALEX JOHNSON (NPI# 1902079015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902079015 |
| Entity Type | Individual |
| Full Name | DR. EDWARD ALEX JOHNSON |
| Credential | M.D. |
| Practice Address |
811 Redgate Ave Norfolk VA 23507-1515 |
| Practice Telephone | 7576687007 |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2019-02-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 0101249802 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS NC | 186RL | 01 |
| NC | 1902079015 | 05 | |
| SC | 315974 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 600 Moye Blvd, Ecu Pediatrics, Greenville, NC 278344300 | 2527442335 | 2527443811 |
| 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 |
| 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 |
| 1649244385 | Edward Johnson | Family Medicine | 473 Cabrillo St Bldg 422, Monterey, CA 93944-3201 | 2006-02-16 |
| Street Address |
811 REDGATE AVE |
| City | NORFOLK |
| State | VA |
| Zip Code | 23507-1515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285290106 | Linda L Maldonado | Family Medicine | 811 Redgate Ave, Norfolk, VA 23507-1515 | 2019-05-16 |
| 1699151290 | Jennifer Lindsey Adams | Physician Assistant | 811 Redgate Ave, Norfolk, VA 23507-1515 | 2015-08-05 |
| 1467830810 | Sarah Lyon Komline | Pediatrics | 811 Redgate Ave, Norfolk, VA 23507 | 2015-05-18 |
| 1841602471 | Kristen-kaye Goulbourne | Pediatrics | 811 Redgate Ave, Norfolk, VA 23507-1515 | 2014-06-02 |
| 1477895050 | Rebecca Ashley Dorner | Anesthesiology | 811 Redgate Ave, Norfolk, VA 23507-1515 | 2013-03-21 |
| 1972823540 | Peter H Ma | Anesthesiology | 811 Redgate Ave, Norfolk, VA 23507-1515 | 2010-06-07 |
| 1275856916 | Mae Mcaliser Shaw | Physician Assistant | 811 Redgate Ave, Post Office Box 11049, Norfolk, VA 23507-1515 | 2010-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790306801 | Paolo Quentin Rigo | Student in an Organized Health Care Education/Training Program | Smith Rogers Hall, 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-04-29 |
| 1811526221 | Sean M Whitty | Student in an Organized Health Care Education/Training Program | Emergency Medicine Residency, Raleigh Building, St 304, 600 Gresham Dr, Norfolk, VA 23507 | 2020-04-07 |
| 1962030643 | Shekinah Joy Vaughn | Student in an Organized Health Care Education/Training Program | 385 Mowbray Arch Ste 203205, Norfolk, VA 23507 | 2020-03-30 |
| 1982231403 | Jaxon Vallely | Student in an Organized Health Care Education/Training Program | 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-03-25 |
| 1437714656 | Kanishk Deep Sharma | Student in an Organized Health Care Education/Training Program | 825 Fairfax Avenue Eastern Virginia Medical School Inte, Suite 445, Norfolk, VA 23507 | 2019-05-02 |
| 1619439460 | Dylan Woolum | Student in an Organized Health Care Education/Training Program | Raleigh Building, Suite 304, 600 Gresham Drive, Norfolk, VA 23507 | 2019-04-02 |
| 1477012623 | Jessie R Jones | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 513a, Norfolk, VA 23507 | 2019-03-18 |
| 1316416787 | Lindsey Sawyer | Genetic Counselor, MS | Childrens Hospital of The Kings Daughters, 601 Childrens Lane, Norfolk, VA 23507 | 2018-11-15 |
| 1881188159 | Patrick Michael Haar | Pharmacist | 601 Pembroke Avenue, Apt 104, Norfolk, VA 23507 | 2018-06-19 |
| 1316438377 | Monika Pajhal | Student in an Organized Health Care Education/Training Program | Eastern Virginia Medical School (internal Medicine), Internal Medicine, 825 Fairfax Ave, Suite 410, Norfolk, VA 23507 | 2018-05-25 |
| Find all providers in zip 23507 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629546106 | Childrens Medical Group Inc | Pediatrics | 1529 International Blvd Ste 301, Norfolk, VA 23513-4802 | 2018-11-02 |
| 1164801700 | Drexel Proctor | Pediatrics | 601 Childrens Ln Fl 6, Norfolk, VA 23507-1910 | 2015-05-28 |
| 1194084038 | Michael James Kochan | Pediatrics | 445 E Freemason St, Apt 2a, Norfolk, VA 23510-2453 | 2012-05-13 |
| 1184853749 | Eric Carroll | Pediatrics | 1562 Mitscher Avenue, Suite 250, Norfolk, VA 23551-2487 | 2009-07-03 |
| 1164650321 | Daniel B Spencer | Pediatrics | 400 Gresham Dr Ste 301, Norfolk, VA 23507-1901 | 2009-06-26 |
| 1548425218 | Mia Jin | Pediatrics | 810 W Princess Anne Rd, Apt 403, Norfolk, VA 23517-1871 | 2008-07-22 |
| 1851559504 | Princess Anne Pediatrics | Pediatrics | 5040 E Princess Anne Rd Ste A, Norfolk, VA 23502-1733 | 2008-05-29 |
| 1790957447 | Kimberly Bryant Schindler | Pediatrics | 1909a Granby Street, Norfolk, VA 23517-2349 | 2008-04-01 |
| 1346425261 | Melissa Buryk | Pediatrics | 1210 Redgate Ave, Norfolk, VA 23507-1331 | 2008-01-09 |
| 1932323904 | Lindsey Elizabeth Moore | Pediatrics | 601 Childrens Ln Dept Of, Norfolk, VA 23507-1910 | 2007-04-12 |
| Find all providers in NORFOLK | ||||
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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.