DWAYNE JOHNSON MD PSC (NPI# 1689701542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689701542 |
| Entity Type | Organization |
| Organization Name | DWAYNE JOHNSON MD PSC |
| Other Organization Name | STRATHMOOR PEDIATRICS |
| Practice Address |
2211 Meadow Dr Louisville KY 40218-1330 |
| Practice Telephone | 5024582577 |
| Practice Fax Number | 5024540105 |
| Mailing Telephone | 5024582577 |
| Mailing Fax Number | 5024540105 |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. DWAYNE EDWARD JOHNSON (PRESIDENT) |
| Authorized Official Telephone | 5024582577 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 28666 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 6594322700 | 05 |
| Other Name | Type Code |
|---|---|
| Strathmoor Pediatrics | Doing Business As Name - Organization |
| Street Address |
2211 MEADOW DR |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40218-1330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457951170 | Okey Patrick Mbadike | Pharmacist | 3616 Buechal By Pass, Louisville, Ky 40218, Louisville, KY 40218 | 2020-10-30 |
| 1992339345 | Rachael P. Abell | Nurse Practitioner | 2210 Buechel Avenue Suite 105, Louisville, KY 40218 | 2020-02-25 |
| 1750938189 | Taylor C Thomas | Nurse Practitioner | 4423 Bardstown Road, Louisville, KY 40218 | 2019-08-21 |
| 1902461692 | Louisville Injury Clinics, Inc | Chiropractor | 4400 Breckenridge Lane, Suite 102, Louisville, KY 40218 | 2019-05-08 |
| 1629564141 | Stepping Stones Counseling | Social Worker | 5414 Bannon Crossing Dr, Louisville, KY 40218 | 2018-07-09 |
| 1396230553 | Kids Without Limits LLC | Home Health | 2204 Bashford Manor Ln, Louisville, KY 40218 | 2018-06-28 |
| 1073008074 | B F P D | Ambulance | 4101 Bardstown Rd, Louisville, KY 40218 | 2018-06-22 |
| 1508358862 | Mary Katherine Biros | Nurse Practitioner | 2202 Buechel Ave Ste 105, Louisville, KY 40218 | 2018-06-03 |
| 1366931644 | Irena Kuca | Student in an Organized Health Care Education/Training Program | 215 Central Avenue Suite 100, Louisville, KY 40218 | 2018-05-02 |
| 1760979124 | Healthy Living Primary Care | General Practice | 4400 Breckenridge Ln Ste 147, Louisville, KY 40218 | 2018-04-20 |
| Find all providers in zip 40218 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306316989 | Jacquee L Mcnear | Pediatrics | 801 Barret Avenue Suite 314, Louisville, KY 40204-1701 | 2018-11-27 |
| 1902292857 | Hayley Redmond | Pediatrics | 571 S Floyd St Ste 332, Louisville, KY 40202 | 2015-04-07 |
| 1770978512 | Michael Bricken | Pediatrics | 760 S Hancock St # B100, Louisville, KY 40203 | 2015-03-30 |
| 1114332236 | Amanda Brian Rogers | Pediatrics | 411 E Chestnut St # Street6, Louisville, KY 40202-1713 | 2014-06-26 |
| 1770900144 | Kathryn Thorne | Pediatrics | 9710 Park Plaza Ave Unit 107, Louisville, KY 40241-2292 | 2014-03-24 |
| 1669717690 | Surjeet Singh Dhanjal | Pediatrics | 1506 Thackeray Dr, Louisville, KY 40205-2410 | 2012-12-03 |
| 1164656443 | Betty Sue Spivack | Pediatrics | 8804 Nottingham Pkwy, Louisville, KY 40222-5217 | 2009-05-14 |
| 1821238528 | James Grant Mumford | Pediatrics | 5100 Commerce Crossings Dr, Louisville, KY 40229-2128 | 2009-02-20 |
| 1033371216 | Jonathan R Malowitz | Pediatrics | 4123 Dutchmans Lane Suite 301, Suburban Medical Plaza 3, Louisville, KY 40207 | 2008-06-27 |
| 1356509954 | Julia Lane Mitchell | Pediatrics | 760 S. Hancock St, B100, Louisville, KY 40203 | 2008-05-30 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40218 |
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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.