Mitchell Steven Johnson

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

350 Constance Blvd
Williams Bay, WI 53191-9547

Phone

(262) 245-5531

NPI assigned

Mar 4, 2019

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1164980611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 SCOTTSWOOD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611072063",
            "telephone_number": "815-378-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 CONSTANCE BLVD",
            "city": "WILLIAMS BAY",
            "state": "WI",
            "postal_code": "531919547",
            "telephone_number": "262-245-5531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MITCHELL",
        "middle_name": "STEVEN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-04",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine A Hanson, PHD
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• John Larry Jansky, PHD
• Craig Joel Johnson, M.D.
• Susan Mary Johnson, RN BSN
• Kingme Inc
• Laura L. Kleber, OT
• Sue McConnell, APSW
• Victoria McHugh, APSW

• Student in an Organized Health Care Education/Training Program in Williams Bay, WI
• Providers in Williams Bay, WI by specialty
• Student in an Organized Health Care Education/Training Program in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; 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.