JOHN GORDON JOHNSON (D.O.) – Emergency Medical Services (Emergency Medicine) Physician, NPI 1174579593

JOHN GORDON JOHNSON (D.O.) is a healthcare provider. based in Georgetown, Texas. specializing in EMERGENCY MEDICINE. They hold the professional credentials D.O.. They hold a License No. M0769 (TX). The NPI Number for JOHN GORDON JOHNSON (D.O.) is 1174579593

Main info

Male
Sole Proprietor
23 Years Of Experience
Name
JOHN GORDON JOHNSON (D.O.)
NPI
1174579593
Phone
(512) 864-2507
Address
505 SHERWOOD CT
Enumeration Date
26 May 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
COLLEGE OF OSTEO MED OF THE PACIFIC AT POMONA
Secondary Phone
5127661400
Graduation Year
2003 (23 years ago)
PAC ID
4284646191
Group Practice PAC ID
8729483854
Professional Enrollment ID
I20060614000199
Address ID
TX786815515RO230XXDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

4,051 EMERGENCY MEDICINE in TX

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Provider Addresses for JOHN GORDON JOHNSON (D.O.)

  • 505, Sherwood Court, Georgetown Village, Georgetown, Williamson County, Texas, 78628, United States

    GEORGETOWN, TX 786284678

    Phone: (512) 864-2507

    Type: Mailing

  • Saint David's Round Rock Medical Center, 2400, Round Rock Avenue, The Oaklands, Round Rock, Williamson County, Texas, 78681, United States

    ROUND ROCK, TX 786814004

    Phone: (512) 341-1000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-06-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060614000199IEmergency MedicineTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 78628)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8729483854View full group profile
NameSpecialtyState
Emergency MedicineNJ
Family PracticeOH
Emergency MedicineNY
Emergency MedicineTX
Emergency MedicineTN
Emergency MedicineTX
Emergency MedicineTX
Emergency MedicineTX
Emergency MedicineTX
Emergency MedicineNE

Reviews

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Frequently asked questions

Can I verify JOHN GORDON JOHNSON (D.O.) with an NPI only?
You can start verification with NPI 1174579593 for JOHN GORDON JOHNSON (D.O.), then check state licensing separately.
Is JOHN GORDON JOHNSON (D.O.) listed as active for patients and plans?
The listing shows JOHN GORDON JOHNSON (D.O.) as active in the NPI system.
What taxonomy line describes JOHN GORDON JOHNSON (D.O.)?
For research purposes, treat JOHN GORDON JOHNSON (D.O.) as Emergency Medical Services (Emergency Medicine) Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for JOHN GORDON JOHNSON (D.O.)?
JOHN GORDON JOHNSON (D.O.)'s geographic hint is Georgetown, Texas in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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