Active NPI
Ian Michael Johnson, DC
- Chiropractor
- Sunnyvale, CA
National Provider Identifier
1063907715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 34216
- Practice address
- 1109 Lund Terrace Sunnyvale Ca, 94089
Sunnyvale, CA 94089 - Phone
- (831) 239-8747
- NPI assigned
- Jun 26, 2018
- 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 | 34216 | CA | Primary |
Addresses
Primary practice location
1109 Lund Terrace Sunnyvale Ca, 94089
Sunnyvale, CA 94089
Mailing address
1109 Lund Terrace Sunnyvale Ca, 94089
Sunnyvale, CA 94089
Phone (831) 239-8747
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34216 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529971200000",
"number": "1063907715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1109 LUND TERRACE SUNNYVALE CA, 94089",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "94089",
"telephone_number": "831-239-8747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1109 LUND TERRACE SUNNYVALE CA, 94089",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "94089",
"telephone_number": "831-239-8747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "IAN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-26",
"last_updated": "2018-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "34216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunnyvale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.