Amy Wang Johnson, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

60891239 Issued in WA

Practice address

1424 Broadway
Everett, WA 98201-1720

Phone

(425) 789-2000

Fax

(425) 789-2096

NPI assigned

May 14, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Community Health Center of Snohomish County

  • Federally Qualified Health Center (FQHC)
  • Everett, WA
  • NPI 1730136367
  Medicare reassignment NPD
• Northeast Valley Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Van Nuys, CA
  • NPI 1629079009
  Medicare reassignment NPD
• Community Health Center of Snohomish County

  • Federally Qualified Health Center (FQHC)
  • Everett, WA
  • NPI 1023830346
  NPD
• Northeast Valley Health Corporation

  • Federally Qualified Health Center (FQHC)
  • San Fernando, CA
  • NPI 1417958943
  NPD
• Northeast Valley Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Santa Clarita, CA
  • NPI 1548960834
  NPD

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

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1053639070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011720",
            "telephone_number": "425-789-2000",
            "fax_number": "425-789-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011720",
            "telephone_number": "425-789-2000",
            "fax_number": "425-789-2096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1172 N Maclay Ave",
            "address_2": "Northeast Valley Health Corporation Att: Medical Admin",
            "address_purpose": "LOCATION",
            "city": "San Fernando",
            "state": "CA",
            "postal_code": "913401328",
            "country_code": "US",
            "telephone_number": "516-902-8625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMY",
        "middle_name": "WANG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-14",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A121626",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "60891239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimorah John, RBT
• Abigail Devin Johnson, DPT, PT
• Aliah Jedidiah Johnson
• Allyson Johnson, LMP
• Amy M Johnson, MD
• Callie Johnson
• Catherine Lynn Johnson, REGISTERED COUNSELOR
• Charlotte Nadeane Johnson, M.S.
• Cherie H Johnson, DPM
• Christina Linnea Johnson

• Pediatrics Physician in Everett, WA
• Providers in Everett, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.