JESS WALTER JOHNSON (NPI# 1679562755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679562755 |
| Entity Type | Individual |
| Full Name | JESS WALTER JOHNSON |
| Credential | PAC |
| Practice Address |
201 S Main St Memorial Medical Center/greenwood Clinic Greenwood WI 54437-9733 |
| Mailing Address |
216 Sunset Pl Memorial Medical Center Neillsville WI 54456-1706 |
| Practice Telephone | 7152673200 |
| Practice Fax Number | 7152673201 |
| Mailing Telephone | 7157433101 |
| Mailing Fax Number | 7157436245 |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2010-02-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 45 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42901000 | 05 |
| Street Address |
201 S MAIN ST MEMORIAL MEDICAL CENTER/GREENWOOD CLINIC |
| City | GREENWOOD |
| State | WI |
| Zip Code | 54437-9733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710361878 | Memorial Hospital Inc. | Non-Pharmacy Dispensing Site | 201 S Main St, Greenwood, WI 54437-9733 | 2015-07-17 |
| 1659360097 | Memorial Hospital, Inc. | Clinic/Center | 201 S Main St, Memorial Medical Center, Greenwood, WI 54437-9733 | 2005-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497833966 | Sport & Spine Clinic Lp | Clinic/Center | 133 South Main Street, Greenwood, WI 54437 | 2006-11-01 |
| 1467538306 | Marshfield Clinic, Inc. | Durable Medical Equipment & Medical Supplies | 102 W. Cannery St., Greenwood, WI 54437 | 2006-10-31 |
| 1437264900 | Scott A Brown | Physician Assistant | 102 W Cannery St, Greenwood, WI 54437 | 2006-08-21 |
| 1063527539 | Gary J Janssen | Family Medicine | 102 W Cannery St, Greenwood, WI 54437 | 2006-08-21 |
| 1003032731 | Eugene Dale Martin | Chiropractor | 134 S Main St, Greenwood, WI 54437-0214 | 2007-04-18 |
| 1437109113 | Lena Marie Abrahamson | Physical Therapist | 133 S Main St, Sport and Spine Clinic, Greenwood, WI 54437-0297 | 2006-05-11 |
| 1912133307 | Amanda Ruff | Registered Nurse | W5574 Lovers Rd, Greenwood, WI 54437-8316 | 2009-05-31 |
| 1497760359 | Dorothy Jean Roback | Nurse Practitioner | W5682 Lovers Rd, Greenwood, WI 54437-8317 | 2006-07-29 |
| 1740804491 | Strides Equestrian Therapeutic Center LLC | Community/Behavioral Health | W6769 Colby Factory Rd, Greenwood, WI 54437-9010 | 2020-05-28 |
| 1831676360 | Callie Mae Horstman | Chiropractor | 124 N Main St, Greenwood, WI 54437-9419 | 2018-07-27 |
| Find all providers in zip 54437 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780294306 | Pamela Hanley | Physician Assistant | 4953 Aquaduct Dr, Greenwood, IN 46142-7536 | 2020-08-07 |
| 1245868629 | Alexandra Diez Arguelles | Physician Assistant | 402 Vanhoy Dr, Greenwood, IN 46142-9064 | 2020-03-31 |
| 1740745900 | Megan Dewitt Carson | Physician Assistant | 313 Main St Ste A, Greenwood, SC 29646-2757 | 2019-02-01 |
| 1982119699 | Patrick Quinn Dooling | Physician Assistant | 555 E County Line Rd Ste 202, Greenwood, IN 46143-1063 | 2017-12-05 |
| 1083040455 | Megan Eliza Wheeler | Physician Assistant | 501 Epting Ave, Greenwood, SC 29646-4091 | 2013-09-17 |
| 1134442890 | Self Medical Group | Physician Assistant | 115 Academy Avenue, Unit A, Greenwood, SC 29646 | 2010-03-10 |
| 1902025109 | Richard David Shults | Physician Assistant | 1300 Innovation Pkwy, Greenwood, IN 46143-3625 | 2007-04-25 |
| 1699820530 | Erin Nikou | Physician Assistant | 700 Us 31 South, Greenwood, IN 46143-2401 | 2007-01-23 |
| 1437264900 | Scott A Brown | Physician Assistant | 102 W Cannery St, Greenwood, WI 54437 | 2006-08-21 |
| 1467490276 | Penny R Streby | Physician Assistant | 105 Vinecrest Ct # 500, Greenwood, SC 29646-8031 | 2006-06-03 |
| Find all providers in GREENWOOD | ||||
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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.