GARY A JOHNSON (NPI# 1083682660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083682660 |
| Entity Type | Individual |
| Full Name | GARY A JOHNSON |
| Credential | MD |
| Practice Address |
8940 N Wood Sage Rd Peoria IL 61615-7822 |
| Practice Telephone | 3092433000 |
| Practice Fax Number | 3092433000 |
| Mailing Telephone | 3092433000 |
| Mailing Fax Number | 3092433274 |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2019-01-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
036.12058 | IL | Allopathic & Osteopathic Physicians |
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
04-34519 | KS | Allopathic & Osteopathic Physicians |
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
2012029926 | MO | Allopathic & Osteopathic Physicians |
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
18538 | OK | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164265 | Gary L Johnson | Massage Therapist | 222 Columbus Ave Ste 220, San Francisco, CA 94133-4597 | 2020-11-08 |
| 1689146078 | Gary L Johnson | Marriage & Family Therapist | 1200 Cedar Ln, Tullahoma, TN 37388-2255 | 2018-12-22 |
| 1083085369 | Gary Johnson | Assisted Living Facility | 1539 W Avenue L12, Lancaster, CA 93534-6930 | 2015-10-13 |
| 1184063323 | Gary D Johnson | Pharmacist | 1897 E Fall View Dr, Sandy, UT 84093-7058 | 2013-06-20 |
| 1568709798 | Gary Lewis Johnson | Rehabilitation Practitioner | 9322 Dorrell Ln, 9322 Dorrell Lane, Las Vegas, NV 89149-0172 | 2013-01-08 |
| 1184997074 | Gary Wayne Johnson | Physical Therapist | 987 Nohunta Ct, Cincinnati, OH 45231-2518 | 2012-02-23 |
| 1518259811 | Gary A Johnson | Counselor | 4410 Arapahoe Ave Ste 205, Boulder, CO 80303-1155 | 2011-05-05 |
| 1285931923 | Gary David Johnson | Chiropractor | 413 W Morgan St, Duluth, MN 55811-4432 | 2011-02-15 |
| 1306156930 | Gary Anthony Johnson II | Private Vehicle | 1430 Dighton Ct, Virginia Beach, VA 23464-8624 | 2010-10-17 |
| 1417118217 | Gary Michael Johnson II | Audiologist | 7025 E Mcdowell Rd, Suite 1c, Scottsdale, AZ 85257-3328 | 2008-06-24 |
| Street Address |
8940 N WOOD SAGE RD |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-7822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174522486 | Nguyet A Le-lindqwister | Internal Medicine | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2005-07-19 |
| 1548899834 | Kari A Breckenridge | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2020-04-07 |
| 1295364826 | Jessica Lemmerman | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2020-04-06 |
| 1992330583 | Heather R Pierce | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2020-03-04 |
| 1730713546 | Kim M Scott | Clinical Nurse Specialist | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2020-03-02 |
| 1609411743 | Holly Jo Delinski | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2019-11-13 |
| 1649825514 | Lindsey Lorraine Grys | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2019-08-07 |
| 1336706845 | Jennifer Mendaluk | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2019-05-21 |
| 1750843199 | Elizabeth M Berryman | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2019-04-04 |
| 1477010031 | Cynthia Salazar | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2019-03-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
| 1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
| 1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
| 1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
| Find all providers in zip 61615 | ||||
| Taxonomy Code | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| 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 Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134197833 | Kennth Alan Hodel | Obstetrics & Gynecology | 6915 N Knoxville Ave, Suite 1, Peoria, IL 61614-2851 | 2006-03-09 |
| 1114126364 | Rebecca Jane Byler Dann | Obstetrics & Gynecology | 1 Illini Dr # 1649, Peoria, IL 61605-2576 | 2007-07-17 |
| 1831104645 | Salvatore J Lococo | Obstetrics & Gynecology | 1 Illini Dr, Box 1649, Peoria, IL 61605-2576 | 2006-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174910657 | Allison Margaret Saiz | Obstetrics & Gynecology | 250 E Superior St Ste 5-2175, Chicago, IL 60611-2914 | 2015-04-22 |
| 1053677005 | Carrie Allison Mcilwain | Obstetrics & Gynecology | 6700 W 95th St Ste 330, Oak Lawn, IL 60453-2416 | 2012-04-04 |
| 1891094546 | Joseph P Bonanno | Obstetrics & Gynecology | 1010 Dixie Hwy Ste 313, Chicago Heights, IL 60411-2666 | 2011-03-21 |
| 1841457975 | Assaad Youssef Semaan | Obstetrics & Gynecology | 800 Biesterfield Rd Ste 302, Elk Grove Village, IL 60007-3378 | 2008-05-16 |
| 1598975336 | Nikki Lynn Neubauer | Obstetrics & Gynecology | 6700 West 95th Street, Suite 330, Oak Lawn, IL 60453-2199 | 2007-05-23 |
| 1124126040 | Arthur Herbst | Obstetrics & Gynecology | 5841 South Maryland Mc 2050, Chicago, IL 60657 | 2006-09-21 |
| 1922037787 | Michael Patrick Lowe | Obstetrics & Gynecology | 6700 W 95th St, Suite 330, Oak Lawn, IL 60453-2199 | 2006-07-02 |
| 1649242736 | Addie Alkhas | Obstetrics & Gynecology | 1875 Dempster St Ste 210, Park Ridge, IL 60068-1126 | 2006-02-03 |
| 1003806514 | Ronald E Kimball | Obstetrics & Gynecology | 509 W University Ave, Urbana, IL 61801-1645 | 2005-10-26 |
| 1700876307 | Barbara Buttin | Obstetrics & Gynecology | 25 N. Winfield Rd., Winfield, IL 60190-1295 | 2005-10-25 |
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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.