KEITH W. JOHNSON (NPI# 1407226582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1407226582 |
Entity Type | Individual |
Full Name | KEITH W. JOHNSON |
Other Name | DR. KEITH W. JOHNSON |
Credential | M.D. |
Practice Address |
450 Bayview Dr Roseville MN 55113-6907 |
Practice Telephone | 6516650413 |
Mailing Telephone | 6516650413 |
Enumeration Date | 2015-10-01 |
Last Update Date | 2015-10-01 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
18624 | MN | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780937821 | Keith Michael Johnson | Counselor | 16812 127th Ave, Apt # 7e, Jamaica, NY 11434-3152 | 2012-10-25 |
1467628792 | Keith Emery Johnson | General Practice | 1111 Quewhiffle Rd, Aberdeen, NC 28315-5377 | 2008-05-06 |
1336330810 | Keith David Johnson | Dentist | 26 S Village Dr, Liberty, MO 64068 | 2007-08-08 |
1952529133 | Keith E Johnson | Dentist | 13270 Big Basin Way, Boulder Creek, CA 95006 | 2007-04-23 |
1700929031 | Keith Vincent Johnson | Specialist/Technologist | 13 Fahnestock Rd, Malvern, PA 19355-2104 | 2007-02-15 |
1972669646 | Keith Johnson | Physical Therapist | 2301 Morningside Dr, Jonesboro, AR 72404-8050 | 2006-12-28 |
1467514588 | Keith W.v. Johnson | Orthopaedic Surgery | 6701 Lake Woodlands Dr, 101, The Woodlands, TX 77382-2566 | 2006-12-14 |
1568553147 | Keith Michael Johnson | Chiropractor | 13700 83rd Way N, #200, Maple Grove, MN 55369-7015 | 2006-09-27 |
1487616967 | Keith Patrick Johnson | Specialist | 85 Harristown Road, Suite 103, Glen Rock, NJ 07452 | 2006-04-03 |
1841263159 | Keith A Johnson | Psychiatry & Neurology | 33 Fruit St, Mass General Physican Organization, Boston, MA 02114-2621 | 2006-02-08 |
Street Address |
450 BAYVIEW DR |
City | ROSEVILLE |
State | MN |
Zip Code | 55113-6907 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
1467010330 | Ahmed Issa | Student in an Organized Health Care Education/Training Program | 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 | 2019-06-05 |
1821653833 | Suite Living Senior Care of Little Canada | Assisted Living Facility | 2740 Rice Street, Little Canada, MN 55113 | 2019-05-06 |
1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
1588138473 | Applewood Home Health Care, LLC | Home Health | 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 | 2019-01-14 |
1699251520 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2685 Patton Rd, Roseville, MN 55113 | 2018-07-13 |
1083104145 | Suite Living Senior Care of Roseville | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55113 | 2018-05-15 |
1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
1194223024 | Alissa Hoff | Specialist | 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 | 2018-01-25 |
1841705118 | Kingsland Care Services Incorporated | Case Management | 2301 Rice Street, Suite 101, Roseville, MN 55113 | 2017-12-08 |
Find all providers in zip 55113 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760856934 | Modesto Radiological Medical Group, Inc | Radiology | 2132 Lysander Way, Roseville, CA 95661-3220 | 2015-11-25 |
1497180772 | Mw Healh Associate Inc | Radiology | 901 Sunrise Ave Ste A22, Roseville, CA 95661-4558 | 2013-09-05 |
1962727552 | Yauk Kaung Lee | Radiology | 1380 Lead Hill Blvd Ste 100, Roseville, CA 95661-2941 | 2010-04-07 |
1932426004 | Veena R Iyer | Radiology | 2355 Hwy 36 W., Ste. 100, Roseville, MN 55113 | 2010-04-28 |
1750526083 | Radiological Associates of Sacramento Medical Group Inc | Radiology | 5 Medical Plaza Dr, 130, Roseville, CA 95661-2865 | 2008-12-16 |
1386811230 | Sacramento Radiology Medical Group, Inc. | Radiology | 2110 Professional Dr, Suite 190, Roseville, CA 95661-3752 | 2008-05-09 |
1932397478 | Sentinel Health Staffing | Radiology | 18263 E 10 Mile Rd, Roseville, MI 48066-5805 | 2007-10-10 |
1821020017 | Roland D Demarco | Radiology | 1 Medical Plaza Dr, Roseville, CA 95661-3037 | 2006-07-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457967234 | Central Imaging LLC | Radiology | 3351 Roosevelt Rd, Saint Cloud, MN 56301-6270 | 2020-09-17 |
1053930578 | Dmitriy Shchegolev | Radiology | 14346 Wilson Dr, Eden Prairie, MN 55347-4179 | 2020-04-14 |
1306333109 | John Warren Kirby | Radiology | 200 1st St Sw # 507284, Rochester, MN 55905 | 2018-04-17 |
1861904765 | Stephanie Dykema | Radiology | 6809 Sandlewood Rd, Woodbury, MN 55125-2175 | 2017-10-31 |
1609392349 | Rai Keystone Imaging Services, LLC | Radiology | 5775 Wayzata Blvd Ste 400, St Louis Park, MN 55416-1271 | 2017-08-15 |
1235687088 | Jeffery E. Illman | Radiology | 1082 Southern Ridge Dr Sw, Rochester, MN 55902-1854 | 2016-09-21 |
1164765822 | Robben Andrew Schat | Radiology | 420 Delaware St Se - Mmc 292, Minneapolis, MN 55455-0341 | 2013-04-01 |
1326363102 | Gilda Boroumand | Radiology | 1901 Irving Ave S, Minneapolis, MN 55403-2824 | 2010-04-05 |
1477880276 | Siobhan Moira Flanagan | Radiology | Mmc 292,420 Delaware Street Se, University of Minnesota Department of Radiology, Minneapolis, MN 55455 | 2009-11-16 |
1043478159 | Voyageur Radiology LLC | Radiology | 9975 Dellwood Rd N, Stillwater, MN 55082-9425 | 2008-05-26 |
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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.