Derek K Johnson

MD | Pediatric Allergy-Immunology | Male

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Complete Profile:

Derek K Johnson basic information including his official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Pediatric Allergy/Immunology
Provider Name :	Derek K Johnson
Credential :	MD
Gender :	Male
Sole Proprietor :	Yes

Business Address:

Derek K Johnson address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	3903a Fair Ridge Dr Fairfax, VA, 22033-2938 United States
Phone Number :	703-648-0030
Fax Number :	703-648-9028

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1285622183
NPI Entity Type :	Individual
First Enrolment Date :	13 Oct, 2005
Last Updated On :	27 Feb, 2017

Medicare Participation:

Derek K Johnson participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	4880653369
Medicare Enrollment ID :	I20140917001575
Primary Specialty :	Allergy/immunology
Medical School :	University Of Washington School Of Medicine
Graduation Year :	1995
Accepts Medicare?	Yes. Derek K Johnson accepts medicare insurance.

Group Practice Association:

Derek K Johnson is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Derek K Johnson is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
Privia Medical Group Llc	4385682061	1057	9470 Annapolis Rd Suite 309 Lanham, MD - 207063022 Ph: 2028321800	Yes
Privia Medical Group Llc	4385682061	1057	3903 A Fair Ridge Dr Fairfax, VA - 220332938 Ph: 7036480030	Yes
Privia Medical Group Llc	4385682061	1057	8700 Sudley Rd Suite 220 Manassas, VA - 201104418 Ph: 5713668845	Yes
Privia Medical Group Llc	4385682061	1057	1952 Opitz Blvd Woodbridge, VA - 221913304 Ph: 7034947849	Yes
Privia Medical Group Llc	4385682061	1057	1958 Opitz Blvd Woodbridge, VA - 221913304 Ph: 7034941147	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Derek K Johnson are as mentioned. Primary taxonomy code for Derek K Johnson, MD is 2080P0201X (Pediatrics Pediatric Allergy/Immunology).

Taxonomy Code	Speciality	Primary	License No.	State
2080P0201X	Pediatrics Pediatric Allergy/Immunology	Yes	MD 065160L	PA

Legacy Identifiers:

Other legacy medical identifiers of Derek K Johnson such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.

Identifier	Identifier Type	State	Issuer
0018751530003	MEDICAID	PA

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	3903a Fair Ridge Dr Fairfax, VA, 22033-2938 United States
Phone Number :	703-648-0030
Fax Number :	703-648-9028

Business Location:

Patients can refer following map for directions to Derek K Johnson practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.