Individual provider Active NPI

James Ernest Johnson III, RD

  • Registered Dietitian
  • Stockton, CA
National Provider Identifier
1114816295
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86330715 Issued in CA
Practice address
2349 N California St
Stockton, CA 95204-5505
Phone
(209) 469-2229
NPI assigned
Jul 2, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86330715 CA Primary

Addresses

Primary practice location

2349 N California St
Stockton, CA 95204-5505

Mailing address

PO Box 255228
Sacramento, CA 95865-5228
Phone (800) 470-0071

Other practice location 1

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 550-3962

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260401002772 CA Practitioner - Registered Dietitian Or Nutrition Professional 6901381441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4500 Business Ctr Dr
Fairfield, CA 94534

4500 Business Ctr Dr
Fairfield, CA 94534-6888

PO Box
Suite 255228
Sacramento, CA 95865

PO Box
Suite 255228
Sacramento, CA 95865-5228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Marjorie Nolan Cohn LLC Dietitian, Registered 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.

NPI Registry JSON

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

{
    "created_epoch": "1751414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1114816295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228",
            "telephone_number": "800-470-0071",
            "fax_number": "916-854-6769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2349 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045505",
            "telephone_number": "209-469-2229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Coffee Rd",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953554201",
            "country_code": "US",
            "telephone_number": "209-550-3962",
            "fax_number": "209-491-7528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JAMES",
        "middle_name": "ERNEST",
        "name_suffix": "III",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-02",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86330715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; 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.