Active NPI
Raymond Marc Johnston, D.C, Q.M.E.
- Chiropractor
- San Luis Obispo, CA
National Provider Identifier
1043380512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC11453
- Practice address
- 1150 Grove St
San Luis Obispo, CA 93401-2914 - Phone
- (805) 541-2727
- Fax
- (805) 541-2729
- NPI assigned
- Nov 9, 2006
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC11453 | CA | Primary |
Addresses
Primary practice location
1150 Grove St
San Luis Obispo, CA 93401-2914
Mailing address
1150 Grove St
San Luis Obispo, CA 93401-2914
Phone (805) 541-2727
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WDC11453A | Other | CA | OTHER STATE IDENTIFIER |
| DC11453 | Other | CA | STATE LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11453 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| DC11453 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043380512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1150 GROVE ST",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934012914",
"telephone_number": "805-541-2727",
"fax_number": "805-541-2729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 GROVE ST",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934012914",
"telephone_number": "805-541-2727",
"fax_number": "805-541-2729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "RAYMOND",
"middle_name": "MARC",
"credential": "D.C, Q.M.E.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC11453",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER STATE IDENTIFIER",
"identifier": "WDC11453A",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "DC11453",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.