DR. WILLIAM WALTER JOHNSON M.D.
NPI 1053315028
Preventive Medicine - Addiction Medicine in Jackson, MS

Q: What is William Johnson's NPI number?

The NPI number for William Johnson is 1053315028. It was assigned to this individual provider in the NPPES registry on June 8, 2005.

Q: What is William Johnson's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Addiction Medicine, with taxonomy code 2083A0300X.

Q: When was this NPI record last updated?

The NPPES record for William Johnson was last updated on July 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 08, 2005PECOS Enrolled

1935 LAKELAND DR STE 900, JACKSON, MS 39216(601) 840-1454 Get Directions Write a Review

NPPES record last updated: July 28, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Dr. William Walter Johnson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. WILLIAM WALTER JOHNSON M.D. (NPI 1053315028) is an individual addiction medicine provider in Jackson, Mississippi, licensed in Mississippi (14886) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS and maintains a secondary practice location in New Albany.

NPPES Registry Identity

NPI1053315028

Entity TypeIndividualMale

Primary Taxonomy2083A0300X

Provider Legal NameDR. WILLIAM WALTER JOHNSONCredential: M.D.

Location Address1935 LAKELAND DR STE 900Jackson, MS 39216-5028

Mailing Address536 Royal Pecan WayCollierville, TN 38017-1734 · (662) 538-8009

Phone(601) 840-1454

Sole ProprietorYes

Enumeration DateJune 8, 2005

Last NPPES UpdateJuly 28, 2021

NPPES CertifiedJuly 28, 2021

✔ NPI 1053315028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPreventive Medicine · Addiction MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2083A0300X

License✔ Licensed in MS · 14886

Definition

A physician engaged in the subspecialty practice of Addiction Medicine who specializes in the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction.

Also ListedObstetrics & GynecologyTaxonomy 207V00000X · License 14886 (MS)

1935 LAKELAND DR STE 900, Jackson, MS 39216

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Secondary Practice Location 1

Location 1107 Main St WNew Albany, MS 38652-3324 · Phone (662) 534-0890 · Fax (855) 796-5855

Other Identifiers 3

Medicaid00117218MS

Other743030196MS · Practice Tax Id #

Medicaid09015923MS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. William Walter Johnson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show William Johnson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Signify Health, LLC

393 mi

General Practice

4055 VALLEY VIEW LN STE 700
Dallas, TX 75244

Reassigned Medicare billing, Mississippi enrollment
202 clinicians in this Medicare group

NPI 1689158487 (469) 466-7007

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39216 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$120.41 typical visit price

range $51.65 – $159.18

Typical copayment $30.10 (range $12.91 – $39.79)

Most-billed visit code 99204

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Breast Cancer Screening

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

56%115 patients3/55-star benchmark: 92%

Cervical Cancer Screening

Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…

80%446 patients

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

36%124 patients2/55-star benchmark: 85%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

60%659 patients3/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 100% · 430 patients

Patients tobacco: 37% · 83 patients

87%430 patients4/55-star benchmark: 98%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. GEORGE WOODSON GULLY JR. LPN

Licensed Practical Nurse