ALEX R JOHNSON (MD) – Family Medicine Physician, NPI 1467986307

ALEX R JOHNSON (MD) is a healthcare provider. based in Fort worth, Texas. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 04-45104 (KS). The NPI Number for ALEX R JOHNSON (MD) is 1467986307

Main info

Male
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
ALEX R JOHNSON (MD)
NPI
1467986307
Phone
(817) 702-1173
Address
1500 S MAIN ST
Enumeration Date
18 April 2017
Last Update Date
6 October 2022

Doctor Profile

Medical School Name
UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Secondary Phone
9132942327
Graduation Year
2017 (9 years ago)
PAC ID
3375949670
Group Practice PAC ID
2163311457
Professional Enrollment ID
I20210913001725
Address ID
KS660711314PA2100XDRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:9State licenses:1Digital endpointsOther names

8,705 FAMILY PRACTICE in TX

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Provider Addresses for ALEX R JOHNSON (MD)

  • John Peter Smith Hospital, 1500, South Main Street, Fort Worth, Tarrant County, Texas, 76104, United States

    FORT WORTH, TX 761044917

    Phone: (817) 702-1173

    Type: Mailing

  • 1318 KANSAS DR

    PAOLA, KS 660712107

    Phone: (913) 557-5678

    Fax: (913) 557-5681

    Type: Mailing

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: 2021-09-13

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
I20210913001725IFamily PracticeKSTBD

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 76104)

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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: 2163311457View full group profile
NameSpecialtyState
Family PracticeKS
-KS
Family PracticeMO
Family PracticeKS
Physician AssistantOK
-KS
Emergency Medicine, Family Practice, Geriatric MedicineMO
Physician AssistantKS
Physician AssistantKS
Family PracticeKS

Reviews

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Frequently asked questions

How is ALEX R JOHNSON (MD) identified in CMS data?
CMS-hosted NPPES data lists ALEX R JOHNSON (MD) with NPI 1467986307.
Does CMS list ALEX R JOHNSON (MD) as active?
Yes — ALEX R JOHNSON (MD) is active in the NPI listing used on this page.
What healthcare role does ALEX R JOHNSON (MD) hold?
Scheduling teams often label ALEX R JOHNSON (MD) under Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Does ALEX R JOHNSON (MD) list a practice location?
Patients near Fort Worth, Texas may find ALEX R JOHNSON (MD) in results; validate coverage separately.
Is the information about ALEX R JOHNSON (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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