JOHNSON MEDICAL CLINIC (NPI# 1962623280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962623280 |
Entity Type | Organization |
Organization Name | JOHNSON MEDICAL CLINIC |
Practice Address |
N8434 County Rd S Algoma WI 54201-9515 |
Practice Telephone | 9204875635 |
Mailing Telephone | 9204875635 |
Enumeration Date | 2007-05-02 |
Last Update Date | 2009-01-13 |
Authorized Official Name | DR. CARLA A JOHNSON (OWNER AND SOLE PHYSICIAN) |
Authorized Official Telephone | 9204875635 |
Authorized Official Credential | DO |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | DEA LICENSE | BH5013177 | 01 |
WI | 30094500 | 05 | |
WI | WISCONSIN CORPORATE NUMBE | HO35675 | 01 |
Street Address |
N8434 COUNTY RD S |
City | ALGOMA |
State | WI |
Zip Code | 54201-9515 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740259662 | Carla A Johnson | Neuromusculoskeletal Medicine & OMM | N8434 County Rd S, Algoma, WI 54201-9515 | 2006-03-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609905645 | Rebecca Havel Prust | Dentist | 1223 Lake Street, Algoma, WI 54201 | 2007-03-05 |
1780734418 | Lakeshore Vision Centers, Ltd | Clinic/Center | 1021 Jefferson St., Algoma, WI 54201 | 2007-01-12 |
1306905575 | Alan William Haubenschild | Dentist | 409 5th St, Algoma, WI 54201 | 2006-12-06 |
1336128081 | Lisa Olson | Physician Assistant | 1510 Fremont St, Algoma, Algoma, WI 54201 | 2006-01-11 |
1477559938 | Robert James Anderson | Family Medicine | 831 Parker St, Algoma, WI 54201-0185 | 2005-06-21 |
1841603693 | Katie Ann Lukes | Registered Nurse | 831 Parker St, Algoma, WI 54201-0185 | 2014-06-10 |
1124438478 | Bellin Psychiatric Center Inc | Counselor | 831 Parker St, Algoma, WI 54201-0185 | 2014-05-07 |
1558372094 | City of Algoma | Ambulance | 400 3rd St, Algoma, WI 54201-1211 | 2006-08-10 |
1447291331 | Kay K Secrest | Chiropractor | 316 Steele St, Algoma, WI 54201-1265 | 2006-06-09 |
1528106929 | Secrest Family Chiropractic LLC | Chiropractor | 316 Steele St, Algoma, WI 54201-1265 | 2007-02-01 |
Find all providers in zip 54201 |
Taxonomy Code | 207QA0505X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Adult Medicine |
Definition to come. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427214501 | Muzaffar Baig Mirza | Family Medicine | 2976 Edenberry St, Fitchburg, WI 53711-6950 | 2008-07-29 |
1720101447 | Robert G Montgomery | Family Medicine | 8570 S 116th St, Franklin, WI 53132-8803 | 2007-04-09 |
1447388350 | Robert Earl Kerwin Jr. | Family Medicine | 333 E. Campus Mall, Madison, WI 53715-1381 | 2007-03-01 |
1184768129 | Charles E Larson | Family Medicine | Flci, W10237 Lake Emily Rd, Fox Lake, WI 54935-8525 | 2007-02-15 |
1154411486 | Paul Henry Hunter | Family Medicine | 841 N Broadway Rm 315, Milwaukee, WI 53202-3613 | 2006-10-16 |
1851310411 | Steven Ronald Coenen | Family Medicine | 10 Triparkway, Va Clinic, Appleton, WI 54914 | 2006-07-18 |
1285688713 | Deborah A Luetzow | Family Medicine | 2413 W Rawson Ave, Oak Creek, WI 53154-1323 | 2006-05-20 |
1548257124 | Paul Hankwitz | Family Medicine | 8520 W Oklahoma Ave, Milwaukee, WI 53227-4604 | 2005-09-29 |
1184155194 | Richard Edgar Rieselbach | Family Medicine | 2711 Allen Blvd, Middleton, WI 53562 | 2017-03-22 |
1275978983 | Numale Medical Center LLC | Family Medicine | 2600 N Mayfair Rd, Suite 505, Wauwatosa, WI 53226-1309 | 2013-05-08 |
Find all providers with the same taxonomy |
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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.