DR. MICHAEL GEORGE JOHNSON JR. (NPI# 1457514549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457514549 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL GEORGE JOHNSON JR. |
| Credential | M.D. |
| Practice Address |
28 Crescent St Middletown CT 06457-3654 |
| Mailing Address |
57 S Main St Middletown CT 06457-3606 |
| Practice Telephone | 8603586293 |
| Mailing Telephone | 8606380050 |
| Mailing Fax Number | 8603468836 |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
052808 | CT | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
052808 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 008053944 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 57 S Main St, Middletown, CT 064573606 | 8606380050 | 8603468836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326655150 | Michael Johnson | Massage Therapist | 4344 Promenade Way Unit 304, Marina Del Rey, CA 90292-6293 | 2020-09-25 |
| 1184236648 | Michael L Johnson | Massage Therapist | 5 Skinner Ct, Tomkins Cove, NY 10986-1105 | 2020-08-17 |
| 1902440266 | Michael Cottrell Johnson | Technician | 3812 W. Mercer Way, Mercer Island, WA 98040 | 2019-10-30 |
| 1235772658 | Michael James Johnson | Driver | 173 S 197th Dr, Buckeye, AZ 85326-3069 | 2019-10-18 |
| 1992287130 | Michael Ray Johnson | Counselor | 900 Nw 31 Ave, Suite #2000, Ft Laud, FL 33311 | 2018-09-04 |
| 1932681715 | Michael Kenneth Johnson | Physician Assistant | 5399 Coachman Rd Apt E, Columbus, OH 43220-6270 | 2018-08-29 |
| 1538648860 | Michael Darnel Johnson Sr. | Counselor | 1705 Kinser Ct, Chesapeake, VA 23324-2332 | 2018-08-08 |
| 1821584988 | Michael Todd Johnson | Registered Nurse | 2137 W 70 S, Hurricane, UT 84737-2791 | 2018-07-02 |
| 1003313727 | Michael Olton Johnson | Physician Assistant | 11513 Merrick Blvd, Jamaica, NY 11434 | 2018-04-09 |
| 1578067336 | Michael Everett Johnson | Student in an Organized Health Care Education/Training Program | 1840 E Woodchase Dr, Baton Rouge, LA 70808-4000 | 2018-03-19 |
| Street Address |
28 CRESCENT ST |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-3654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790788859 | Eric B Neadel | Physician Assistant | 28 Crescent St, Middletown, CT 06457-3654 | 2005-05-23 |
| 1861001729 | Adrianne Lynn Wyckoff | Registered Nurse | 28 Crescent St, Middletown, CT 06457-3650 | 2020-07-27 |
| 1639791577 | Peder Johnsen | Nurse Practitioner | 28 Crescent St, Middletown, CT 06457-3654 | 2020-05-14 |
| 1275171530 | Lisa Ann Tringali | Recreation Therapist | 28 Crescent St, Middletown, CT 06457-3654 | 2019-12-18 |
| 1528600160 | Antonella Rosa Sferrazza | Counselor | 28 Crescent St, Middletown, CT 06457-3654 | 2019-10-15 |
| 1548801830 | Michael Tammaro | Physician Assistant | 28 Crescent St, Middletown, CT 06457-3654 | 2019-10-08 |
| 1699240705 | Mary Theresa Doyle | Social Worker | 28 Crescent St, Middletown, CT 06457-3650 | 2018-10-05 |
| 1649761040 | Emily Eklof | Nurse Practitioner | 28 Crescent St, Middletown, CT 06457 | 2018-05-22 |
| 1285141077 | Christine O'grady | Social Worker | 28 Crescent St, Middletown, CT 06457-3654 | 2018-01-03 |
| 1871022293 | Jacqueline Mary Atkinson | Physician Assistant | 28 Crescent St, Middletown, CT 06457-3654 | 2017-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
| 1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
| 1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
| 1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
| 1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
| 1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
| 1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
| 1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
| Find all providers in zip 06457 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417269317 | Daniel Macarthur | Radiology | 28 Crescent St, Middletown, CT 06457-3654 | 2010-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083859649 | Thomas V Divinagracia | Radiology | 85 Seymour St., Suite 409, Hartford, CT 06106 | 2008-12-11 |
| 1336176270 | Daniel Jay Kase | Radiology | 57 Commercial Blvd, Torrington, CT 06790-3097 | 2006-06-27 |
| 1184686933 | Bryan Thomas Suchecki | Radiology | 65 Douglas Rd, Glastonbury, CT 06033-2219 | 2006-04-05 |
| 1669458766 | Domenic A. Zambuto | Radiology | 110 Albany Tpke, 209, Canton, CT 06019-2547 | 2005-12-20 |
| 1417933961 | Fernando F. Illescas | Radiology | 701 Cottage Grove Rd Ste E110, Bloomfield, CT 06002-3085 | 2005-12-16 |
| 1700494887 | Advanced Radiology Partners LLC | Radiology | 15 Corporate Dr, Trumbull, CT 06611-1351 | 2020-07-15 |
| 1417574708 | K&h Medical Ct Pllc | Radiology | 160 West Street, Builing 1 Suite 7, Cromwell, CT 06416 | 2020-07-02 |
| 1174168926 | Vinay Madan, Md, LLC | Radiology | 35 Danbury Rd, Wilton, CT 06897-4428 | 2019-11-14 |
| 1639739634 | Vein Centers, LLC | Radiology | 23 Cedar St, New Britain, CT 06052-1301 | 2019-06-20 |
| 1417361627 | James Gardner | Radiology | 20 York St, New Haven, CT 06510-3220 | 2014-06-16 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLETOWN |
| Zip Code | 06457 |
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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.