GREG R JOHNSON (NPI# 1013960269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013960269 |
| Entity Type | Individual |
| Full Name | GREG R JOHNSON |
| Credential | DO |
| Practice Address |
1900 Carew Street Suite 3a Fort Wayne IN 46805-4765 |
| Mailing Address |
1234 E Dupont Rd Suite 1 Fort Wayne IN 46825-1545 |
| Practice Telephone | 2603739919 |
| Practice Fax Number | 2603736315 |
| Mailing Telephone | 2603739700 |
| Mailing Fax Number | 2603739740 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2013-03-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
02001531 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200015220 | 05 | |
| IN | ANTHEM | 000000675115 | 01 |
| IN | R.R. MEDICARE | P00895098 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578811527 | Greg L Johnson | Physical Therapy Assistant | 305 E Miel De Luna Ave, Tucumcari, NM 88401-3810 | 2012-08-23 |
| 1366467722 | Greg Sinding Johnson | Psychiatry & Neurology | 555 Dayton Street, Ste C, Edmonds, WA 92083-3476 | 2006-07-13 |
| 1669432142 | Greg Eric Johnson | Dentist | 104 Preston St, Hartford, CT 06114-2500 | 2006-03-27 |
| 1871025049 | Greg Johnson | Student in an Organized Health Care Education/Training Program | 867 N Fair Oaks Ave, Pasadena, CA 91103-3050 | 2017-03-28 |
| 1073886248 | Greg Michael Johnson | Psychologist | 142 E Maumee St, Adrian, MI 49221-2735 | 2012-02-17 |
| 1134429335 | Greg Johnson | Specialist/Technologist, Other | 3290 Northside Pkwy Nw, Suite 300, Atlanta, GA 30327-2273 | 2010-10-22 |
| 1699928432 | Greg Anthony Johnson | Orthotist | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2008-10-24 |
| 1548419138 | Greg Michael Johnson | Internal Medicine | 1 Veterans Dr, Minneapolis, MN 55417-2309 | 2008-09-18 |
| 1154416485 | Greg William Johnson | Counselor | 5301 Buckeystown Pike, Frederick, MD 21704-8370 | 2006-10-03 |
| 1508969973 | Greg W Johnson | Family Medicine | 130 E Boise Ave, Boise, ID 83706 | 2006-09-07 |
| Street Address |
1900 CAREW STREET SUITE 3A |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46805-4765 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
| 1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
| 1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
| 1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
| 1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
| 1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
| 1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
| 1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
| 1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
| 1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
| Find all providers in zip 46805 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225684368 | Fort Wayne Vascular Care LLC | Internal Medicine | 1833 Magnavox Way # 100, Fort Wayne, IN 46804-1539 | 2019-08-14 |
| 1326319724 | Robert Wayne Dettmer | Internal Medicine | 2935 Ambleside Way, Fort Wayne, IN 46804-2443 | 2012-01-18 |
| 1801054358 | Maria Regina Valcarcel | Internal Medicine | 7836 W Jefferson Blvd Ste 101, Nephrology Associates of Northern Indiana, Fort Wayne, IN 46804-4178 | 2008-05-30 |
| 1710938592 | Swapna Joseph | Internal Medicine | 7836 W. Jefferson Blvd. Suite 101, Fort Wayne, IN 46804 | 2006-05-15 |
| 1396731212 | Guy Chadwick Asher Jr. | Internal Medicine | 7836 W Jefferson Blvd, Suite 101, Fort Wayne, IN 46804-4165 | 2005-09-26 |
| 1013203561 | Abdurrahman M Hamadah | Internal Medicine | 7836 W Jefferson Blvd Ste 101, Fort Wayne, IN 46804-4178 | 2011-06-23 |
| 1619207941 | Richard Loy Nielsen | Internal Medicine | 11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2010-01-08 |
| 1659531325 | Muhammad Ubaid Ullah | Internal Medicine | 11104 Parkview Circle Dr, S-330, Fort Wayne, IN 46845-1672 | 2008-06-16 |
| 1558460378 | Three Rivers Medical Associates, LLC | Internal Medicine | 7910 W Jefferson Blvd, Fort Wayne, IN 46804-4159 | 2006-09-21 |
| 1568416865 | Andrew W O'shaughnessy | Internal Medicine | 7836 W Jefferson Blvd, Suite 101, Fort Wayne, IN 46804-4165 | 2006-05-20 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46805 |
Please comment or provide details below to improve the information on GREG R JOHNSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.