Individual provider Active NPI

Debra Jolyn Johnson, M.D.

  • Plastic Surgery Physician
  • Sacramento, CA
National Provider Identifier
1174697072
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
G48021 Issued in CA
Practice address
95 Scripps Dr
Sacramento, CA 95825-6320
Phone
(916) 929-1833
Fax
(916) 929-1833
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X G48021 CA Primary

Addresses

Primary practice location

95 Scripps Dr
Sacramento, CA 95825-6320

Mailing address

95 Scripps Dr
Sacramento, CA 95825-6320
Phone (916) 929-1833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48021CAMDMarriage & Family Therapist
G48021CAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Plastic Surgery Center Current Accepting new patients

Locations

95 Scripps Dr
Sacramento, CA 95825
Phone (916) 929-1833

Organizations & group practices 1

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1174697072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 SCRIPPS DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256320",
            "telephone_number": "916-929-1833",
            "fax_number": "916-929-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 SCRIPPS DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256320",
            "telephone_number": "916-929-1833",
            "fax_number": "916-929-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEBRA",
        "middle_name": "JOLYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G48021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.