MEDICARE: MICHAEL NOLEN JOHNSTON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207PP0204X	Pediatric Emergency Medicine (Emergency Medicine) Physician	41119	TN
2	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	19184	AL
3	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	022289	LA
4	207P00000X	Emergency Medicine Physician	41119	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487698361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL NOLEN JOHNSTON MD

Provider Business Mailing Address
First Line	:	3841 GREEN HILLS VILLAGE DR STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2691
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1313 21ST AVE SOUTH
Second Line	:	703 OXFORD HOUSE
City	:	NASHVILLE
State	:	TN
Zip	:	37232-4700
Country	:	US
Telephone Number	:	615-936-0087
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	04/24/2025

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