Individual provider Active NPI

Emily E Johnston, MD

  • Emergency Medicine Physician
  • Tacoma, WA
National Provider Identifier
1124230024
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
60170963 Issued in WA
Practice address
9040 Jackson Ave
Tacoma, WA 98431-8642
Phone
(253) 968-3884
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 1679 SD
Emergency Medicine Physician 207P00000X 60170963 WA Primary

Addresses

Primary practice location

9040 Jackson Ave
Tacoma, WA 98431-8642

Mailing address

PO Box 2857
Jackson, WY 83001-2857
Phone (206) 200-9497

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, SD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101103000652 WA Practitioner - Emergency Medicine 4789878729 Reassigns benefits to 2 organizations
I20171201001388 SD Practitioner - Emergency Medicine 4789878729 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60170963WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Oct 20, 2017 Accepting new patients
Lewis County Hospital District No. 1 CurrentSince Oct 31, 2022 Accepting new patients
Avera McKennan CurrentSince Oct 20, 2017 Accepting new patients
Lewis County Hospital District No. 1 Emergency Medicine CurrentSince Oct 31, 2022 Accepting new patients
Avera McKennan Current Accepting new patients
Lewis County Hospital District No 1 Current Accepting new patients
Beezley Springs Inpatient Services LLC Emergency Medicine Past Accepting new patients
Teton Valley Health Care Inc Past Accepting new patients
Medical Imaging Associates of Idaho Falls, Inc Past Accepting new patients
Teton Valley Health Care Inc Emergency Medicine Past Accepting new patients

Locations

301 Flynn Dr
Milbank, SD 57252
Phone (605) 432-4587

300 W 5th St
Miller, SD 57362
Phone (605) 853-0158

Organizations & group practices 10

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1124230024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2857",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830012857",
            "telephone_number": "206-200-9497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984318642",
            "telephone_number": "253-968-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "EMILY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SD",
            "license": "1679",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "60170963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.