David P Johnson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1157 Issued in ME

Practice address

165 Poplar Street
Suite #1
Millinocket, ME 04462

Phone

(207) 723-2034

Fax

(207) 723-3006

NPI assigned

Feb 10, 2009

Last updated

Sep 10, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5664/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir-usa.unify.chbase.com/org/penob-eadbba22

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Penobscot Valley Hospital

  • Critical Access Hospital
  • Lincoln, ME
  • NPI 1093716086
  NPD (past)

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

{
    "created_epoch": "1234224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1053550350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SOMERSET STREET",
            "city": "MILLINOCKET",
            "state": "ME",
            "postal_code": "04462",
            "telephone_number": "207-723-5161",
            "fax_number": "207-564-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 POPLAR STREET",
            "address_2": "SUITE #1",
            "city": "MILLINOCKET",
            "state": "ME",
            "postal_code": "04462",
            "telephone_number": "207-723-2034",
            "fax_number": "207-723-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-10",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brendan D Hurley, DC
• Cynthia E Ingerson
• Randy D Jackson, PA-C
• Stephannie Jacobs, RN
• Deborha Jander-Piergross, RN
• Josh H Jones, RN
• Thomas Edward Jones II, MOTR/L
• Katahdin Friends, Inc. (Kfi)
• Katahdin Health Care LLC
• Katahdin Nursing Home

• Physician Assistant in Millinocket, ME
• Providers in Millinocket, ME by specialty
• Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.