Individual provider Active NPI

Yvette Marie Johnson, DC

  • Chiropractor
  • Long Beach, CA
National Provider Identifier
1083022933
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
32954 Issued in CA
Practice address
5855 E Naples PLZ
Suite 113
Long Beach, CA 90803-5060
Phone
(562) 810-4916
NPI assigned
Jul 23, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 32954 CA Primary

Addresses

Primary practice location

5855 E Naples PLZ
Suite 113
Long Beach, CA 90803-5060

Mailing address

5855 Naples Plaza
Suite 113
Long Beach, CA 90803-3209
Phone (562) 810-4916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200422000493 CA Practitioner - Chiropractic 2062774136

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5855 E Naples PLZ
Suite 113
Long Beach, CA 90803-5077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32954CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Shore Wellness LLC Chiropractor CurrentSince Feb 26, 2020 Accepting new patients

Locations

15520 Rockfield Blvd
Ste A200
Irvine, CA 92618

5855 E Naples Plz
Ste 113
Long Beach, CA 90803
Phone (562) 810-4916

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1083022933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 NAPLES PLAZA",
            "address_2": "SUITE 113",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908033209",
            "telephone_number": "562-810-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 E NAPLES PLZ",
            "address_2": "SUITE 113",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908035060",
            "telephone_number": "562-810-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "YVETTE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-23",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "32954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.