Dr. Jack Simpson Johnson , MD
General Practice • Cookeville, TN
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jack Johnson has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Jack Johnson, MD was a registered General Practice practicing in Cookeville, TN. Throughout an active medical career spanning 10 years, Dr. Johnson provided care at the practice location at 979 MT. VERNON RD. until profile deactivation on 2020-05-18.
Practice Location & Contact Primary Location
979 Mt. Vernon Rd.
Cookeville, TN 38501
Specialty Benchmarks & Practice Insights
Comparative analytics for General Practice in Cookeville, TN
Practicing in Cookeville, TN (202 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 208D00000X
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on May 18, 2020
NPI status registered as active in NPPES database
Registered at 979 MT. VERNON RD., COOKEVILLE, TN 38501 (Tel: 9315266895)
Registered at 979 MT. VERNON RD., COOKEVILLE, TN 38501 (Tel: 9315266895)
Recorded as JACK JOHNSON, MD
General Practice (License #TN0002073 in TN)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
979 Mt. Vernon Rd.
Cookeville, TN 38501
Phone: 9315266895
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