JUDD C JOHNSTON (NPI# 1033163878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033163878 |
| Entity Type | Individual |
| Full Name | JUDD C JOHNSTON |
| Credential | MD |
| Practice Address |
901 Lakeshore Dr Ishpeming MI 49849-1367 |
| Practice Telephone | 9064852634 |
| Practice Fax Number | 9064852344 |
| Mailing Telephone | 9064852634 |
| Mailing Fax Number | 9064852344 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2013-06-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0105X |
Pathology Specialization: Clinical Pathology/Laboratory Medicine |
4301050861 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE SHIELD | 2205245571 | 01 |
| MI | 1862790 | 05 | |
| RAILROAD MEDICARE | 220016108 | 01 |
| Street Address |
901 LAKESHORE DR |
| City | ISHPEMING |
| State | MI |
| Zip Code | 49849-1367 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356331128 | Virginia Frances Smith | Nurse Practitioner | 901 Lakeshore Dr, Ishpeming, MI 49849-1367 | 2005-10-24 |
| 1821635442 | Melissa Ann Wachter | Registered Nurse | 901 Lakeshore Dr, Ishpeming, MI 49849-1367 | 2019-12-02 |
| 1295378909 | Chauntelle Leigh Taylor | Nurse Practitioner | 901 Lakeshore Dr, Ishpeming, MI 49849-1367 | 2019-10-25 |
| 1386285609 | Karissa Rae Roudebush | Nurse Practitioner | 901 Lakeshore Dr, Ishpeming, MI 49849-1367 | 2019-10-08 |
| 1851855183 | Abbey Kelto | Physical Therapist | 901 Lakeshore Dr, Ishpeming, MI 49849-1367 | 2019-01-31 |
| 1558846675 | Mandi Mae Wilkins | Nurse Practitioner | 901 Lakeshore Dr, Ishpeming, MI 49849-1367 | 2018-09-25 |
| 1396228250 | Brooke Ann Montgomery | Occupational Therapist | 901 Lakeshore Dr, Ishpeming, MI 49849-1367 | 2018-09-07 |
| 1134601685 | Shannon Marie Scott | Nurse Practitioner | 901 Lakeshore Dr, Ishpeming, MI 49849-1367 | 2018-08-31 |
| 1871087809 | Bell Physician Practices Inc | Health Educator | 901 Lakeshore Dr, Ishpeming, MI 49849-1367 | 2018-06-22 |
| 1134610371 | Brett Ian Peterson | Dietitian, Registered | 901 Lakeshore Dr, Ishpeming, MI 49849-1367 | 2018-05-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639707912 | Trevor Doren | Physician Assistant | 813 Braastads Road, Ishpeming, MI 49849 | 2020-03-31 |
| 1336795244 | Ishpeming Nursing & Rehab Center, LLC | Skilled Nursing Facility | 435 Rd Pl, Ishpeming, MI 49849 | 2019-08-15 |
| 1316351224 | Great Lakes Recovery Centers | Clinic/Center | 97 S. 4th Street, Suite C, Ishpeming, MI 49849 | 2014-06-18 |
| 1689098857 | Karen Duquette | Psychologist | 540 E Division St, Ishpeming, MI 49849 | 2014-02-09 |
| 1063796456 | Brian E. Anderson, D.d.s., Pllc | Clinic/Center | 125 N. Pansy St, Ishpeming, MI 49849 | 2011-10-04 |
| 1689658973 | Joel A Johnson | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 901 Lakeshore Dr., Ishpeming, MI 49849 | 2005-12-01 |
| 1538791975 | David Scott Swanson | Registered Nurse | 901 Lakeshore Drive, Ishpeming, MI 49849 | 2020-02-04 |
| 1669831756 | Bell Auxiliary | Voluntary or Charitable | 901 Lakeshore Drive, Ishpeming, MI 49849 | 2016-02-17 |
| 1982831749 | Brian Edward Anderson | Dentist | 125 N Pansy Street, Ishpeming, MI 49849 | 2009-06-18 |
| 1356546378 | Kelly Rose Menge | Obstetrics & Gynecology | 901 Lakeshore Dr., Ishpeming, MI 49849 | 2007-06-19 |
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| Taxonomy Code | 207ZP0105X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Clinical Pathology/Laboratory Medicine |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pathology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033748728 | Steve Martin | Pathology | 5575 Conner St Ste A, Detroit, MI 48213-6400 | 2020-04-04 |
| 1083020150 | Maria Vida Villegas Singson | Pathology | 30946 Roselawn Dr, Warren, MI 48088-5948 | 2014-07-09 |
| 1205264579 | Visiting Nurse Services of Michigan | Pathology | 4000 S Saginaw St, Flint, MI 48507-2604 | 2013-10-24 |
| 1982996831 | Yasin K Ahmed | Pathology | 919 Shore Club Dr, Saint Clair Shores, MI 48080-1562 | 2011-05-11 |
| 1215102272 | Aspirus Iron River Hospital & Clinics, Inc. | Pathology | 1400 West Ice Lake Road, Iron River, MI 49935 | 2008-04-29 |
| 1437205200 | Shirley Siew | Pathology | A622 E Fee Hall, East Lansing, MI 48824 | 2007-01-26 |
| 1558443432 | Thomas E Wilson | Pathology | 1500 East Medical Center, 2nd Floor University Hospital Recp Pathology, Ann Arbor, MI 48109-5054 | 2006-10-19 |
| 1790274678 | Heritage Labs, Inc. | Pathology | 2891 E Maple Rd, Troy, MI 48083-6106 | 2018-05-06 |
| 1013424399 | Tox Testing Inc | Pathology | 16100 19 Mile Rd Ste 200, Clinton Township, MI 48038-1148 | 2018-01-08 |
| 1265835110 | Ghassan Allo | Pathology | 2799 W Grand Blvd, Henry Ford Hospital, Dept of Pathology K-6, Detroit, MI 48202-2608 | 2014-10-07 |
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| 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.