Jerry Lee Johnson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3987-012 Issued in WI

Practice address

4312 Mormon Coulee Rd
La Crosse, WI 54601-7908

Phone

(608) 788-7111

Fax

(608) 788-7113

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
• IL PPO Downstate
• IL HMO C-SNP

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.

• Johnson Chiropractic, Inc

  • Chiropractor
  • La Crosse, WI
  • NPI 1043332232
  Medicare reassignment NPD Authorized official
• Hundt Chiropractic, LLC

  • Chiropractor
  • La Crosse, WI
  • NPI 1871786632
  NPD (past)
• Vernon Clinic of Chiropractic, Inc

  • Chiropractor
  • Viroqua, WI
  • NPI 1053512194
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003907817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1891",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546021891",
            "telephone_number": "608-788-7111",
            "fax_number": "608-788-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4312 MORMON COULEE RD",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546017908",
            "telephone_number": "608-788-7111",
            "fax_number": "608-788-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JERRY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3987-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Johnson
• Gordon L Johnson, MD
• Heather Johnson
• Jared Johnson
• Jeanne M Johnson, MD
• Jessica Marie Johnson, NP
• John Kenneth Johnson, R.PH.
• Jordan Scott Johnson, DPM
• Kimberly Maria Johnson, LCSW, CSAC
• Kimberly Marie Johnson, BSW

• Chiropractor in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.