Paul E. Johnson, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

018242 Issued in CT

Practice address

201 Boston Post Rd
Waterford, CT 06385-2805

Phone

(860) 536-3078

Fax

(860) 444-2015

NPI assigned

Jul 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ear,Nose and Throat Associates of Southeastern Connecticut, P.C.

  • Otolaryngology Physician
  • Waterford, CT
  • NPI 1518044395
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124040738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 BOSTON POST RD",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063852805",
            "telephone_number": "860-536-3078",
            "fax_number": "860-444-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 BOSTON POST RD",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063852805",
            "telephone_number": "860-536-3078",
            "fax_number": "860-444-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAUL",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CT",
            "license": "018242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1182427",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Ann M. Jakub, LPC
• Adelina Nicole Jakuba, MS, APRN, FNP-BC
• Brenna Lauren Jaskiewicz, MS
• Vijay Jayaraman, M.D
• Joshua S. John, DMD
• Jennifer Michelle Jordan, D.C.
• Jr Drew & Ep Raccio, D.M.D.
• Jwa Services Inc
• Jwa Services Inc
• Kab Counseling Services PLLC

• Otolaryngology Physician in Waterford, CT
• Providers in Waterford, CT by specialty
• Otolaryngology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.