NPIMap

Individual provider Active NPI

Cris Edward Johnson, MD

  • Family Medicine Physician
  • Lacey, WA
National Provider Identifier
1144390261
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00035172 Issued in WA
Practice address
5130 Corporate Center CT SE
Lacey, WA 98503-5957
Phone
(360) 413-8600
Fax
(360) 413-8822
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00035172 WA Primary

Addresses

Primary practice location

5130 Corporate Center CT SE
Lacey, WA 98503-5957

Mailing address

5130 Corporate Center CT SE
Lacey, WA 98503-5957
Phone (360) 413-8600

Other identifiers 2

IdentifierTypeStateIssuer
8222796MedicaidWA
1144390261OtherWANPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20100803000919 WA Practitioner - Family PracticePractitioner - General Practice 4183771769 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Medical Center Physicians LLCGroup PAC ID 3678639879, 59 clinicians

Practice addresses (Care Compare)

3920 Capital Mall Dr SW
Suite 200
Olympia, WA 98502-8701
Phone (360) 459-7282

Hospital & facility affiliations

  • Assured Home Health and Hospice Home health agency, Centralia, WA, CCN 507042
  • Multicare Good Samaritan Home Health Home health agency, Tacoma, WA, CCN 507046
  • Providence at Home With Compassus, Puget Sound South Home health agency, Lacey, WA, CCN 507004
  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024
  • Capital Medical Center Hospital, Olympia, WA, CCN 500139
  • Mason General Hospital & Family of Clinics Hospital, Shelton, WA, CCN 501336
  • Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Medical Center Physicians LLC CurrentSince Apr 1, 2024 Accepting new patients
Capital Medical Center Physicians LLC Family Medicine CurrentSince Apr 1, 2024 Accepting new patients
Pioneer Family Practice, PLLC Family Medicine CurrentSince Jul 1, 2001 Accepting new patients
Capital Medical Center Physicians LLC Family Medicine Past Accepting new patients

Locations

5130 Corporate Center Ct SE
Lacey, WA 98503
Phone (360) 413-8600

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

3920 Capital Mall Dr SW
Ste 200
Olympia, WA 98502
Phone (360) 459-7282

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCCGAA

Organizations & group practices 4

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1144390261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 CORPORATE CENTER CT SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985035957",
            "telephone_number": "360-413-8600",
            "fax_number": "360-413-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 CORPORATE CENTER CT SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985035957",
            "telephone_number": "360-413-8600",
            "fax_number": "360-413-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CRIS",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00035172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8222796",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1144390261",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

Verify at the official NPI Registry.