NPIMap

Individual provider Active NPI

Kathryn Johnson, MD

  • Surgery Physician
  • Coos Bay, OR
National Provider Identifier
1154827228
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD218480 Issued in OR
Practice address
1900 Woodland Dr
Coos Bay, OR 97420-2099
Phone
(541) 267-5151
NPI assigned
Apr 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X MD218480 OR Primary

Addresses

Primary practice location

1900 Woodland Dr
Coos Bay, OR 97420-2099

Mailing address

1900 Woodland Dr
Coos Bay, OR 97420-2099
Phone (541) 267-5151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20240122003008 OR Practitioner - General Surgery 1557612819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of North Dakota School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Bend Medical Center IncGroup PAC ID 5597677716, 92 clinicians

Practice addresses (Care Compare)

1900 Woodland Dr
Coos Bay, OR 97420-2045
Phone (541) 267-5151

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy119
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy15
Upper gastrointestinal (GI) endoscopy for acid reflux95
Melanoma (skin cancer) excision37
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Bend Medical Center Inc CurrentSince Feb 1, 2024 Accepting new patients
Bay Area Hospital District Past Accepting new patients
North Bend Medical Center Inc Past Accepting new patients

Locations

1900 Woodland Dr
Coos Bay, OR 97420
Phone (541) 267-5151

Organizations & group practices 3

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 5

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": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1154827228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202099",
            "telephone_number": "541-267-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202099",
            "telephone_number": "541-267-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHRYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD218480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

Verify at the official NPI Registry.