Active NPI
Joseph A Johnson
- Prevention Professional
- Queen Creek, AZ
National Provider Identifier
1003684317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- 000000
- Practice address
- 2791 W Mineral Butte Dr
Queen Creek, AZ 85144-4734 - Phone
- (623) 703-5765
- NPI assigned
- Dec 15, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prevention Professional | 405300000X | 000000 | AZ | Primary |
Addresses
Primary practice location
2791 W Mineral Butte Dr
Queen Creek, AZ 85144-4734
Mailing address
2791 W Mineral Butte Dr
Queen Creek, AZ 85144-4734
Phone (623) 703-5765
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000000 | AZ | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702598400000",
"number": "1003684317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2791 W MINERAL BUTTE DR",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851444734",
"telephone_number": "623-703-5765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2791 W MINERAL BUTTE DR",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851444734",
"telephone_number": "623-703-5765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JOSEPH",
"middle_name": "A",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-12-15",
"last_updated": "2023-12-15",
"certification_date": "2023-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Prevention Professional",
"state": "AZ",
"license": "000000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queen Creek, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.