David Isaac Johnson, D.C. – Chiropractor

Key facts

NPI: 1003238148
Entity type: Individual (NPI type 1)
Primary specialty: Chiropractor 111N00000X
License: CH60434321 (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
Sex: Male
Sole proprietor: No

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 and National Provider Directory roles.

Beacon Chiropractic Co Chiropractor · Vancouver, WA · NPI 1699199109

Medicare reassignment NPD Authorized official CHIROPRACTOR · WA
Opdahl Chiropractic Office Inc. Chiropractor · Battle Ground, WA · NPI 1134315781

Medicare reassignment NPD CHIROPRACTOR · WA
Hoffman Chiropractic Inc. Chiropractor · Vancouver, WA · NPI 1023683414

NPD CHIROPRACTOR
Family Chiropractic at Salmon Creek Inc Chiropractor · Vancouver, WA · NPI 1407052350

NPD (past) CHIROPRACTOR

Medicare Care Compare profile

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

Medicare participation

Medicare fee-for-service enrollment: Enrolled in WA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20160504001991	WA	Practitioner - Chiropractic	2365741824	Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
CH60434321	WA	MD	Chiropractor

Practice roles (4 of 6)

Organization	Specialty	Status	New patients
Beacon Chiropractic Co	Chiropractor	Current since Jul 19, 2022	Accepting new patients
Opdahl Chiropractic Office Inc.	Chiropractor	Current since Mar 28, 2016	Accepting new patients
Hoffman Chiropractic Inc.	Chiropractor	Current since Jul 19, 2022	Accepting new patients
Family Chiropractic at Salmon Creek Inc	Chiropractor	Past since May 2, 2007	Accepting new patients

Locations

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

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

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

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor	111N00000X	CH60434321	WA	Yes

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 7, 2022.

{
    "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

All providers in Vancouver, WA · Chiropractor in Washington

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.