GARY M JOHNSON (NPI# 1700971116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700971116 |
| Entity Type | Individual |
| Full Name | GARY M JOHNSON |
| Credential | PA-C |
| Practice Address |
1055 S Wells Ave Suite 120 Reno NV 89502-2586 |
| Mailing Address |
680 S Rock Blvd Reno NV 89502-4113 |
| Practice Telephone | 7753296300 |
| Practice Fax Number | 7753233136 |
| Mailing Telephone | 7753296300 |
| Mailing Fax Number | 7753233136 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2015-03-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA946 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 003116008 | 05 | |
| NV | 001516008 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164265 | Gary L Johnson | Massage Therapist | 222 Columbus Ave Ste 220, San Francisco, CA 94133-4597 | 2020-11-08 |
| 1689146078 | Gary L Johnson | Marriage & Family Therapist | 1200 Cedar Ln, Tullahoma, TN 37388-2255 | 2018-12-22 |
| 1083085369 | Gary Johnson | Assisted Living Facility | 1539 W Avenue L12, Lancaster, CA 93534-6930 | 2015-10-13 |
| 1184063323 | Gary D Johnson | Pharmacist | 1897 E Fall View Dr, Sandy, UT 84093-7058 | 2013-06-20 |
| 1568709798 | Gary Lewis Johnson | Rehabilitation Practitioner | 9322 Dorrell Ln, 9322 Dorrell Lane, Las Vegas, NV 89149-0172 | 2013-01-08 |
| 1184997074 | Gary Wayne Johnson | Physical Therapist | 987 Nohunta Ct, Cincinnati, OH 45231-2518 | 2012-02-23 |
| 1518259811 | Gary A Johnson | Counselor | 4410 Arapahoe Ave Ste 205, Boulder, CO 80303-1155 | 2011-05-05 |
| 1285931923 | Gary David Johnson | Chiropractor | 413 W Morgan St, Duluth, MN 55811-4432 | 2011-02-15 |
| 1306156930 | Gary Anthony Johnson II | Private Vehicle | 1430 Dighton Ct, Virginia Beach, VA 23464-8624 | 2010-10-17 |
| 1417118217 | Gary Michael Johnson II | Audiologist | 7025 E Mcdowell Rd, Suite 1c, Scottsdale, AZ 85257-3328 | 2008-06-24 |
| Street Address |
1055 S WELLS AVE SUITE 120 |
| City | RENO |
| State | NV |
| Zip Code | 89502-2586 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346233392 | Steven A Shane | Pediatrics | 1055 S Wells Ave, Reno, NV 89502-2550 | 2005-08-24 |
| 1285233486 | Melanie Hacklander | Nurse Practitioner | 1055 S Wells Ave, Reno, NV 89502-2550 | 2020-10-20 |
| 1770117756 | Elizabeth Patricia Lewis | Registered Nurse | 1055 S Wells Ave, Reno, NV 89502-2550 | 2020-02-27 |
| 1407492853 | Lucia Amanda Sanchez | Physician Assistant | 1055 S Wells Ave, Reno, NV 89502-2550 | 2019-11-20 |
| 1760030712 | Luis Fernando Rodriguez | Physician Assistant | 1055 S Wells Ave, Reno, NV 89502-2550 | 2019-09-03 |
| 1841844511 | Aaron V Blackham | Social Worker | 1055 S Wells Ave, Reno, NV 89502-2550 | 2019-07-30 |
| 1023661048 | Jordan Diane Forman | Nurse Practitioner | 1055 S Wells Ave, Reno, NV 89502-2550 | 2019-07-18 |
| 1174182166 | Cecilia Bowers | Physician Assistant | 1055 S Wells Ave, Reno, NV 89502-2550 | 2019-06-12 |
| 1649752106 | Kristyn Mcdougall | Nurse Practitioner | 1055 S Wells Ave, Reno, NV 89502-2550 | 2018-08-31 |
| 1326532714 | Caitlin Alexandra White | Family Medicine | 1055 S Wells Ave, Reno, NV 89502-2550 | 2018-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314264 | State of Nevada | Community/Behavioral Health | 4600 Kietzke Lane Bldg D, Reno, NV 89502 | 2020-07-23 |
| 1447879259 | Ryan Johnson | Student in an Organized Health Care Education/Training Program | 1155 Mill St. W-11, Reno, NV 89502 | 2020-04-11 |
| 1396378063 | Domingko Loney | Chore Provider | 1325 Air Motive Wat St 262, Reno, NV 89502 | 2020-02-20 |
| 1053954842 | Derek Craig | Home Health Aide | 1000 Havard Way #29, Reno, NV 89502 | 2019-10-24 |
| 1477108124 | Marisa Rachael Traversie | Nurse Practitioner | 910 Vista Boulevard, Sparks, NV 89502 | 2019-08-08 |
| 1912564675 | Patrick Llewellyn Merrill | Social Worker | 975 Kirman Ave - Ch 116, Reno, NV 89502 | 2019-05-28 |
| 1881154706 | Naresh Kumar Veerabattini | Student in an Organized Health Care Education/Training Program | 1155 Mill St, Renown Regional Medical Center, W11 Academic Department Offices, Reno, NV 89502 | 2019-03-25 |
| 1053899187 | Daphne London | Behavioral Analyst | 1325 Airmotive Way Ste 260, Reno, NV 89502 | 2018-07-31 |
| 1790271609 | Jennifer J Padolina | Optometrist | 2296 Kietzke Ln, Reno, NV 89502 | 2018-07-03 |
| 1336630185 | Lindsey Cherie Cooper | Technician | 3563 Sol Grande Ct, Reno, NV 89502 | 2018-05-27 |
| Find all providers in zip 89502 | ||||
| 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 |
|---|---|---|---|---|
| 1407474695 | Katherine Lynn Mauldin | Physician Assistant | Redfield Campus Nell J. Redfield Bldg. A Suite 104, 18600 Wedge Parkway, Reno, NV 89511 | 2020-07-14 |
| 1497370514 | Jantima Shannon Becker | Physician Assistant | 1060 Crosswater Dr, Reno, NV 89523-7100 | 2020-06-15 |
| 1073148508 | Megan Marie Brandon | Physician Assistant | 236 W 6th St Ste 3, Reno, NV 89503-4517 | 2020-03-05 |
| 1487216719 | Abigail Freeman | Physician Assistant | 10745 Double R Blvd # 13, Reno, NV 89521-8979 | 2019-07-08 |
| 1902465321 | Michael Edward Callahan | Physician Assistant | 10509 Professional Cir Ste 101, Reno, NV 89521-4883 | 2019-06-10 |
| 1821656174 | Samantha Audrey Mcdougal | Physician Assistant | 450 Haleb Ct, Reno, NV 89521-8345 | 2019-06-02 |
| 1588039085 | Stat Wound Care Services LLC | Physician Assistant | 4790 Caughlin Pkwy # 379, Reno, NV 89519-0907 | 2015-12-09 |
| 1174998702 | Adeo Wound Services LLC | Physician Assistant | 4790 Caughlin Pkwy # 380, Reno, NV 89519-0907 | 2015-12-08 |
| 1649640814 | Aleah Kristin Hartung | Physician Assistant | 960 Caughlin Xing, #100, Reno, NV 89519-0611 | 2015-09-30 |
| 1235422304 | Ashley L Thompson | Physician Assistant | 1075 N Hills Blvd Ste 180, Reno, NV 89506-6799 | 2011-05-24 |
| Find all providers in RENO | ||||
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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.