Tamara Lynn Johnson, MED, RD,LD,CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD-D-10203616 Issued in OR

Practice address

525 Madrona Ave
Port Orford, OR 97465-9552

Phone

(541) 332-3861

NPI assigned

Nov 29, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

Practice roles

Locations

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.

• Curry Health District

  • Critical Access Hospital
  • Gold Beach, OR
  • NPI 1487696985

  OR

  Medicare reassignment NPD
• Curry Health District

  • Rural Health Clinic/Center
  • Gold Beach, OR
  • NPI 1770303968
  NPD

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

{
    "created_epoch": "1574985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574985600000",
    "number": "1164069951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 MADRONA AVE",
            "city": "PORT ORFORD",
            "state": "OR",
            "postal_code": "974659552",
            "telephone_number": "541-332-3861",
            "fax_number": "541-332-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 MADRONA AVE",
            "city": "PORT ORFORD",
            "state": "OR",
            "postal_code": "974659552",
            "telephone_number": "541-332-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TAMARA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MED, RD,LD,CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-29",
        "last_updated": "2019-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-10203616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bandon Community Health Ctr
• Curry Health District
• Malori Page Dixon, CCHMC, NCC
• Janine Jason, M.D.
• Sandra P. Johnson, FNP
• Harold D Lowry, MD
• Joan Anne McNerlin
• Thomas E. Pitchford III, MD
• Port Orford Community Ambulance Inc
• Port Orford- Langlois School District

• All providers in Port Orford, OR
• Registered Dietitian in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.