NPIMap

Individual provider Active NPI

Jeremy Scott Johnston, PA-C

  • Physician Assistant
  • Eugene, OR
National Provider Identifier
1013286335
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA168476 Issued in OR
Practice address
1605 Oak St
Eugene, OR 97401-4022
Phone
(541) 246-3400
Fax
(541) 246-3342
NPI assigned
Dec 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X PA168476 OR
Interventional Pain Medicine Physician 208VP0014X PA168476 OR
Physician Assistant 363A00000X PA168476 OR Primary

Addresses

Primary practice location

1605 Oak St
Eugene, OR 97401-4022

Mailing address

2852 Willamette St Ste 400
Eugene, OR 97405-8200
Phone (541) 246-3400

Other practice location 1

1625 Oak St
Eugene, OR 97401-4022
Phone (541) 623-0874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141022002197 OR Practitioner - Physician Assistant 9537323407 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA168476ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Medical Foundation of Tillamook CurrentSince Jan 12, 2019 Accepting new patients
Northwest Medical Foundation of Tillamook CurrentSince Jan 12, 2019 Accepting new patients
St. Charles Health System, Inc. CurrentSince Jun 1, 2016 Accepting new patients
Chest Diagnostic Therapeutic SVCS & Transit Nursing of TX, Inc Past Accepting new patients
Riverwalk Clinic, LLC Past Accepting new patients
Medspring of Texas, PA Past Accepting new patients
River City Observation Services PLLC Past Accepting new patients
River City Emergency Physicians, PLLC Past Accepting new patients
Digital Clinic LLC PastSince Jan 1, 2021 Accepting new patients
Alamo City Medical Group, PLLC PastSince Apr 1, 2013 Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

1000 3rd St
Tillamook, OR 97141
Phone (503) 251-6129

1000 3rd St
#M
Tillamook, OR 97141
Phone (503) 815-2260

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1013286335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2852 WILLAMETTE ST STE 400",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974058200",
            "telephone_number": "541-246-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 OAK ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014022",
            "telephone_number": "541-246-3400",
            "fax_number": "541-246-3342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1625 Oak St",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974014022",
            "country_code": "US",
            "telephone_number": "541-623-0874",
            "fax_number": "541-246-3421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "JEREMY",
        "middle_name": "SCOTT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-14",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "OR",
            "license": "PA168476",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "OR",
            "license": "PA168476",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA168476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.