Individual provider Active NPI

Ricky J Johnston, D.C.

  • Chiropractor
  • Walla Walla, WA
National Provider Identifier
1083694566
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2196 Issued in WA
Practice address
216 N Roosevelt
Walla Walla, WA 99362-2537
Phone
(509) 529-6200
Fax
(509) 529-6200
NPI assigned
Jan 19, 2006
Last updated
Oct 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2196 WA Primary

Addresses

Primary practice location

216 N Roosevelt
Walla Walla, WA 99362-2537

Mailing address

216 N Roosevelt
Walla Walla, WA 99362-2537
Phone (509) 529-6200

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

LicenseStateTypeSpecialty
2196WAMDChiropractor

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1083694566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 N ROOSEVELT",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622537",
            "telephone_number": "509-529-6200",
            "fax_number": "509-529-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 N ROOSEVELT",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622537",
            "telephone_number": "509-529-6200",
            "fax_number": "509-529-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "RICKY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "2196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.