KATHRYN MANDELBAUM JOHNSON (NPI# 1205911328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205911328 |
| Entity Type | Individual |
| Full Name | KATHRYN MANDELBAUM JOHNSON |
| Credential | PA-C |
| Practice Address |
2575 Spruce St Boulder CO 80302-3806 |
| Mailing Address |
345 Maxwell Ave Boulder CO 80304-3972 |
| Practice Telephone | 3034493594 |
| Practice Fax Number | 3034493112 |
| Mailing Telephone | 3035445783 |
| Mailing Fax Number | 3034412388 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2012-10-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
3470 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710469101 | Kathryn Johnson | Social Worker | 5 Market Sq Ste 109, Amesbury, MA 01913-2440 | 2018-08-31 |
| 1467931246 | Kathryn Rosa Johnson | Optometrist | 3763 Franklin Rd Sw, Roanoke, VA 24014-2261 | 2018-08-12 |
| 1710403274 | Kathryn Lynn Johnson | Nurse Practitioner | 101 Tiger Way, Pikeville, KY 41501-6543 | 2017-08-16 |
| 1235664061 | Kathryn Leigh Johnson | Pharmacist | University of Kentucky Healthcare 800 Rose St Rm H110, Lexington, KY 40536-4796 | 2017-04-30 |
| 1982074548 | Kathryn Taraneh Johnson | Physician Assistant | 1532 E. San Bernardino Ave, Suite A2, Pomona, CA 91762-4913 | 2015-09-25 |
| 1558770271 | Kathryn Lorraine Johnson | Specialist/Technologist | Gonzaga University 502 E Boone, Spokane, WA 99258-0066 | 2014-08-06 |
| 1831501154 | Kathryn Johnson | Speech-Language Pathologist | 874 11th St, Idaho Falls, ID 83404-5058 | 2014-05-21 |
| 1194069849 | Kathryn Elise Johnson | Counselor | 7100 S Cooper St Ste 9, Arlington, TX 76001 | 2012-11-19 |
| 1669716809 | Kathryn Marie Johnson | Audiologist | 1409 N Challenger Dr, Pueblo West, CO 81007-3918 | 2012-11-10 |
| 1730433095 | Kathryn Johnson | Occupational Therapy Assistant | 5828 Orchid Jungle Ln, North Las Vegas, NV 89031-1173 | 2012-11-07 |
| Street Address |
2575 SPRUCE ST |
| City | BOULDER |
| State | CO |
| Zip Code | 80302-3806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457348724 | Dawn Renee Hutchinson | Internal Medicine | 2575 Spruce St, Boulder, CO 80302-3806 | 2005-10-03 |
| 1942856745 | Boulder Community Health | Clinic/Center | 2575 Spruce St, Boulder, CO 80302-3806 | 2019-08-16 |
| 1386983542 | Rebecca Ann Kasperbauer | Physician Assistant | 2575 Spruce St, Boulder, CO 80302-3806 | 2013-02-07 |
| 1447433867 | Mary Louise Langlois | Internal Medicine | 2575 Spruce St, Boulder, CO 80302-3806 | 2007-12-07 |
| 1346360617 | Spruce Street Internal Medicine | Specialist | 2575 Spruce St, Boulder, CO 80302 | 2007-03-30 |
| 1477577153 | Kristina A Anton-schnell | Internal Medicine | 2575 Spruce St, Boulder, CO 80302-3806 | 2006-07-27 |
| 1487613972 | Sheila Lt Ling | Internal Medicine | 2575 Spruce St, Boulder, CO 80302-3806 | 2006-03-22 |
| 1033108642 | Amy Oconor Maiocco | Internal Medicine | 2575 Spruce St, Boulder, CO 80302-3806 | 2005-10-17 |
| 1316936198 | Hillary L Browne | Internal Medicine | 2575 Spruce St, Boulder, CO 80302-3806 | 2005-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323347 | Aviva Naomi Bannerman | Counselor | 2299pearlst., Boulder, CO 80302 | 2020-07-22 |
| 1205480845 | Mark L Sipowicz | Counselor | 100 Arapahoe Avenue, Boulder, CO 80302 | 2019-08-01 |
| 1366909806 | Brett Adamek | Counselor | 2027 Broadway, Suite E, Boulder, CO 80302 | 2019-02-20 |
| 1124592225 | Stepheny Antrobus | Counselor | 100 Arapahoe Lane, Suite 12, Boulder, CO 80302 | 2019-01-11 |
| 1942721337 | Sasha Marvel Hope | Nutritionist | 2260 Baseline Road #102, Boulder, CO 80302 | 2017-07-06 |
| 1073045365 | Mark Shusterman | Internal Medicine | 2133 5th Street, Boulder, CO 80302 | 2017-03-28 |
| 1316489396 | Agnieszka Spuzak | Nutritionist | 1267 Fourmile Canyon Dr, Boulder, CO 80302 | 2016-11-08 |
| 1265980031 | Tanya Robertson | Physical Therapy Assistant | 1633 Grove Street, Boulder, CO 80302 | 2016-09-21 |
| 1699142380 | Libbey Occupational Therapy Services LLC | Occupational Therapist | 100 West Arapahoe Ln, Suite 12, Boulder, CO 80302 | 2015-08-28 |
| 1831597244 | Annemarie Curran Prairie | Counselor | 2505 Walnut St., Ste 303, Boulder, CO 80302 | 2014-12-17 |
| Find all providers in zip 80302 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386919793 | Laura Beth Hundemann | Physician Assistant | 2919 Valmont Rd Ste 204, Boulder, CO 80301-1350 | 2012-03-19 |
| 1356326888 | Alison Merser Moore | Physician Assistant | 1949 Pearl St, Boulder, CO 80302-4496 | 2005-12-07 |
| 1184175952 | Reed P Fischer | Physician Assistant | 1755 48th St Ste 200, Boulder, CO 80301-2712 | 2016-10-17 |
| 1366802035 | Rachel Morr | Physician Assistant | 2525 13th St, Boulder, CO 80304-4104 | 2016-02-24 |
| 1386918977 | Jennifer Lau Stanzel | Physician Assistant | 4745 Arapahoe Ave, Suite 110, Boulder, CO 80303-1080 | 2012-02-29 |
| 1417268970 | Zachary D Kahn | Physician Assistant | 2750 Broadway St, Boulder, CO 80304-3573 | 2010-06-29 |
| 1770812588 | Jonathan Ellis Welker | Physician Assistant | 4801 Riverbend Rd Ste 200, Boulder, CO 80301-2613 | 2009-12-08 |
| 1295068682 | Melissa J Guerri | Physician Assistant | 4745 Arapahoe Ave, #130, Boulder, CO 80303-1080 | 2009-09-16 |
| 1528297439 | Rebecca Jane Barnes | Physician Assistant | 805 S Broadway St, Ste 103, Boulder, CO 80305-5971 | 2009-07-13 |
| 1023140035 | Darrin Paul Guitreau | Physician Assistant | 4895 Riverbend Rd, Boulder, CO 80301-2640 | 2007-03-12 |
| Find all providers in BOULDER | ||||
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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.