Individual provider Active NPI

David Isaac Johnson, D.C.

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1003238148
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60434321 Issued in WA
Practice address
11500 NE 119TH St Ste 104
Vancouver, WA 98662-1643
Phone
(360) 326-3396
Fax
(360) 369-0015
NPI assigned
Jan 8, 2014
Last updated
Sep 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH60434321 WA Primary

Addresses

Primary practice location

11500 NE 119TH St Ste 104
Vancouver, WA 98662-1643

Mailing address

11500 NE 119TH St Ste 104
Vancouver, WA 98662-1643
Phone (360) 326-3396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160504001991 WA Practitioner - Chiropractic 2365741824 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11500 NE 119TH St
Suite 104
Vancouver, WA 98662-1643
Phone (360) 326-3396

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hoffman Chiropractic Inc. Chiropractor CurrentSince Jul 19, 2022 Accepting new patients
Opdahl Chiropractic Office Inc. Chiropractor CurrentSince Mar 28, 2016 Accepting new patients
Beacon Chiropractic Co Chiropractor CurrentSince Jul 19, 2022 Accepting new patients
Family Chiropractic at Salmon Creek Inc Chiropractor PastSince May 2, 2007 Accepting new patients

Locations

105 N Parkway Ave
Battle Ground, WA 98604
Phone (360) 637-2790

105 N Parkway Ave
Ste 101
Battle Ground, WA 98604
Phone (360) 666-6001

11500 NE 119th St
Ste 104
Vancouver, WA 98662
Phone (360) 326-3396

11815 NE Highway 99
Ste A
Vancouver, WA 98686
Phone (360) 696-4405

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1389139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1003238148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11500 NE 119TH ST STE 104",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986621643",
            "telephone_number": "360-326-3396",
            "fax_number": "360-369-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 NE 119TH ST STE 104",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986621643",
            "telephone_number": "360-326-3396",
            "fax_number": "360-369-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-08",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60434321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.