DR. KEVIN RAYMOND JOHNSON I (NPI# 1750387049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750387049 |
| Entity Type | Individual |
| Full Name | DR. KEVIN RAYMOND JOHNSON I |
| Credential | M.D. |
| Practice Address |
1510 Division St Ste 210 Oregon City OR 97045-1599 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5037236525 |
| Practice Fax Number | 5037236508 |
| Mailing Telephone | 5032156494 |
| Mailing Fax Number | 5032156644 |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2011-06-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | MD16564 | OR | Allopathic & Osteopathic Physicians |
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MD16564 | OR | Allopathic & Osteopathic Physicians |
| N | 208C00000X | Colon & Rectal Surgery | MD16564 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | RR MEDICARE | P00924574 | 01 |
| OR | 128541 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912463704 | Kevin Johnson | Chiropractor | 2601 E Chapman Ave Ste 214, Fullerton, CA 92831-3737 | 2019-02-16 |
| 1558834234 | Kevin Timothy Johnson | Physician Assistant | 411 Naylor Mill Rd, Salisbury, MD 21801-1191 | 2019-01-06 |
| 1790283588 | Kevin Johnson | Case Manager/Care Coordinator | 201 W. Springfield Ave, Knoxville, TN 37917 | 2018-01-26 |
| 1205384955 | Kevin Johnson Jr. | Community Health Worker | 1261 Roslyn Ave, Akron, OH 44320-3424 | 2016-09-12 |
| 1073949400 | Kevin William Johnson | Counselor | 1147 16th St N, St Petersburg, FL 33705-1104 | 2013-09-17 |
| 1669752200 | Kevin L Johnson | Pharmacist | 2600 S 48th St, Lincoln, NE 68506-2502 | 2011-08-26 |
| 1346536463 | Kevin Charles Johnson | Pharmacist | 747 Highway 259 North, Kilgore, TX 75662-5175 | 2011-06-27 |
| 1770806374 | Kevin Neil Johnson | Physical Medicine & Rehabilitation | 9913 214th St W Ste B, Lakeville, MN 55044-1914 | 2010-03-10 |
| 1326280991 | Kevin Anthony Johnson | Family Medicine | 1400 Hancock Blvd, #1208, Daytona Beach, FL 32114 | 2009-03-29 |
| 1558566588 | Kevin Charles Johnson | Speech-Language Pathologist | 8620 Holly Dr, Suite 230, Everett, WA 98208-1825 | 2007-06-19 |
| Street Address |
1510 DIVISION ST STE 210 |
| City | OREGON CITY |
| State | OR |
| Zip Code | 97045-1599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558819235 | Heather Mirenda | Social Worker | 1510 Division St, 90, Oregon City, OR 97045-1581 | 2016-09-12 |
| 1538454665 | Providence Health & Services - Oregon | Internal Medicine | 1510 Division St, Suite 130, Oregon City, OR 97045-1572 | 2011-06-16 |
| 1346533585 | Providence Health & Services - Oregon | Clinic/Center | 1510 Division St, Suite 100, Oregon City, OR 97045-1572 | 2011-05-20 |
| 1144529306 | Jennifer Eileen Shepard | Pediatrics | 1510 Division St, Suite 280, Oregon City, OR 97045-1581 | 2011-03-26 |
| 1194057497 | Providence Health & Services - Oregon | Clinic/Center | 1510 Division St, Ste 170, Oregon City, OR 97045-1581 | 2010-02-11 |
| 1730411034 | Providence Health & Services - Oregon | Clinic/Center | 1510 Division St, Suite 210, Oregon City, OR 97045-1599 | 2010-02-11 |
| 1821320128 | Providence Health & Services - Oregon | Clinic/Center | 1510 Division St, Ste 170, Oregon City, OR 97045-2551 | 2010-02-11 |
| 1891026647 | Providence Health & Services - Oregon | Clinic/Center | 1510 Division St, Suite 200, Oregon City, OR 97045-1599 | 2010-01-19 |
| 1942454087 | Willamette Falls Hospital | Physical Medicine & Rehabilitation | 1510 Division St, Suite 170, Oregon City, OR 97045-1581 | 2008-11-14 |
| 1962665232 | Willamette Falls Hospital | Surgery | 1510 Division St, Ste 210, Oregon City, OR 97045-1581 | 2008-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528625621 | Dylan Wile | Physical Therapist | 19721 Or 213, Oregon City, OR 97045 | 2019-05-23 |
| 1952871576 | April Saylor | Dental Hygienist | 15530 S. Morel Dr, Oregon City, OR 97045 | 2018-11-27 |
| 1598251688 | Sara Noelle Wetten | Dental Assistant | 1900 Mclouglin Blvd #68, Oregon City, OR 97045 | 2018-07-02 |
| 1649761941 | Carol Ann Cranfill | Specialist | 1001 Molalla Ave. Ste 206, Oregon City, OR 97045 | 2018-05-22 |
| 1790286029 | Kathleen Walker | Registered Nurse | 110 Beaverceek Rd., Oregon City, OR 97045 | 2018-02-22 |
| 1174032429 | Amanda Brannin | Dental Hygienist | 15018 Pebble Beach Dr, Oregon City, OR 97045 | 2017-09-28 |
| 1003332669 | Clackamas Medical Supplies | Durable Medical Equipment & Medical Supplies | 2050 Beavercreek Rd. Ste 101-385, Oregon, OR 97045 | 2017-08-16 |
| 1154870129 | Staci S Meador | Nurse Practitioner | 1508 Division St Ste 200, Oregon City, OR 97045 | 2016-10-01 |
| 1821541939 | Samuel R. Sabo | General Practice | 18171 Waldow Rd., Oregon City, OR 97045 | 2016-07-26 |
| 1619339967 | Carly Chambers | Physical Therapist | 1630 S Beavercreeak Rd, Suite A, Oregon City, OR 97045 | 2016-03-25 |
| Find all providers in zip 97045 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255675039 | Edward Joseph Serres | Surgery | 700 Molalla Ave., Clackamas Volunteers In Medicine, Oregon City, OR 97045 | 2012-11-19 |
| 1508976473 | Eleazar D Lawson | Surgery | 1510 Division St Ste 210, Oregon City, OR 97045-1599 | 2006-08-30 |
| 1417927351 | John Joseph Antolik | Surgery | 728 Molalla Ave, #c, Oregon City, OR 97045 | 2006-01-24 |
| 1962665232 | Willamette Falls Hospital | Surgery | 1510 Division St, Ste 210, Oregon City, OR 97045-1581 | 2008-07-08 |
| 1477538064 | Shawn M Morgan | Surgery | 1510 Division St, Suite 210, Oregon City, OR 97045-1599 | 2005-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386168029 | Northwest Minimally Invasive Surgery, LLC | Surgery | 2222 Nw Lovejoy St Ste 322, Portland, OR 97210-5101 | 2017-08-02 |
| 1366897399 | Andreas Hennig | Surgery | 783 Nw Naito Pkwy Apt 502, Portland, OR 97209-4755 | 2016-04-27 |
| 1366809048 | Mid-columbia Medical Center | Surgery | 1810 E. 19th St. #225, The Dalles, OR 97058 | 2016-01-26 |
| 1972983781 | Horizon Surgery Clinic | Surgery | 6542 Se Lake Rd Ste 101, Milwaukie, OR 97222-2245 | 2015-06-05 |
| 1871989467 | Cameron Cangelose | Surgery | 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239-3098 | 2015-04-09 |
| 1396157962 | Fernando Leon | Surgery | 2221 Sw First Ave Apt 2322, Portland, OR 97201-5023 | 2014-05-29 |
| 1114337466 | Thomas B Knowles | Surgery | 1130 Nw 22nd Ave Ste 500, Portland, OR 97210-2976 | 2014-05-07 |
| 1861811770 | Peter Andrew Sweeny | Surgery | 705 Elm St Sw Ste 300, Albany, OR 97321-1958 | 2014-04-08 |
| 1811310063 | George Craig Merhoff Sr. | Surgery | 6090 Sunset Ridge Rd, Klamath Falls, OR 97601-9386 | 2014-01-23 |
| 1659714160 | Sean Tyler Watters | Surgery | 5050 Ne Hoyt St Ste 651, Portland, OR 97213 | 2013-04-15 |
| Find all providers with the same taxonomy | ||||
| City | OREGON CITY |
| Zip Code | 97045 |
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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.