Active NPI
Thomas Joseph Johnson, MD
- Surgery Physician
- Osceola, WI
National Provider Identifier
1104892900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 38459
- Practice address
- 204 3Rd Ave W
Osceola, WI 54020-8031 - Phone
- (715) 294-4898
- NPI assigned
- Feb 23, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 38459 | WI | Primary |
Addresses
Primary practice location
204 3Rd Ave W
Osceola, WI 54020-8031
Mailing address
204 3Rd Ave W
PO Box 597
Osceola, WI 54020-8031
Phone (715) 294-4898
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
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ladd Memorial Hospital | Past | Accepting new patients | |
| Lake Side Surgical Associates SC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Specialist
- Sturgeon Bay, WI
- NPI 1699779355
-
- Clinic/Center
- Scandia, MN
- NPI 1700195542
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267747200000",
"number": "1104892900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 3RD AVE W",
"address_2": "PO BOX 597",
"city": "OSCEOLA",
"state": "WI",
"postal_code": "540208031",
"telephone_number": "715-294-4898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 3RD AVE W",
"city": "OSCEOLA",
"state": "WI",
"postal_code": "540208031",
"telephone_number": "715-294-4898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "THOMAS",
"middle_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-23",
"last_updated": "2010-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "38459",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Osceola, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.