NPIMap

Individual provider Active NPI

David Johansen, M.D.

  • Internal Medicine Physician
  • Grand Junction, CO
National Provider Identifier
1114248465
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
52217 Issued in CO
Practice address
607 28 1/4 Rd
Grand Junction, CO 81506-6023
Phone
(970) 243-3300
Fax
(970) 243-4464
NPI assigned
Jun 21, 2010
Last updated
Dec 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 52217 CO Primary

Addresses

Primary practice location

607 28 1/4 Rd
Grand Junction, CO 81506-6023

Mailing address

PO Box 1687
Grand Junction, CO 81502-1687
Phone (970) 256-6322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130729000627 CO Practitioner - Internal Medicine 1557502804 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Creighton University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Group LLCGroup PAC ID 1052612785, 109 clinicians

Practice addresses (Care Compare)

607 28
Grand Junction, CO 81506-6018
Phone (970) 243-3300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions14
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
52217COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Group, LLC Internal Medicine Current Accepting new patients
Community Medical Group, LLC CurrentSince Nov 15, 2015 Accepting new patients
Colorado West Healthcare System CurrentSince Dec 1, 2013 Accepting new patients
Colorado West Healthcare System Current Accepting new patients
Community Medical Group, LLC CurrentSince Nov 15, 2015 Accepting new patients
Colorado West Healthcare System CurrentSince Dec 1, 2013 Accepting new patients
Colorado West Regional Mental Health, Inc. Past Accepting new patients
Western Medical Associates, P.C. Past Accepting new patients
Community Medical Group, LLC Past Accepting new patients

Locations

2351 G Rd
Grand Junction, CO 81505
Phone (970) 242-0920

744 Horizon Ct
Ste 301
Grand Junction, CO 81506
Phone (970) 243-4020

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/849/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1114248465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1687",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815021687",
            "telephone_number": "970-256-6322",
            "fax_number": "970-263-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 28 1/4 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815066023",
            "telephone_number": "970-243-3300",
            "fax_number": "970-243-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSEN",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-21",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "52217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.