Individual provider Active NPI

Chatt Allan Johnson, MD

  • Vascular Surgery Physician
  • Tacoma, WA
National Provider Identifier
1184605347
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD60327871 Issued in WA
Practice address
9040 Jackson Avenue
Tacoma, WA 98431-4882
Phone
(253) 968-2252
NPI assigned
Nov 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X MD60327871 WA Primary
Emergency Medicine Physician 207P00000X J8003 TX
Surgery Physician 208600000X MD60327871 WA
Surgery Physician 208600000X J8003 TX
Vascular Surgery Physician 2086S0129X J8003 TX

Addresses

Primary practice location

9040 Jackson Avenue
Tacoma, WA 98431-4882

Mailing address

9040 Jackson Ave
Tacoma, WA 98431-0001
Phone (253) 958-2252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR, CO3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20130709000396 WA Practitioner - Vascular Surgery 5092816306 Reassigns benefits to 2 organizations
I20190905000662 OR Practitioner - Vascular Surgery 5092816306 Reassigns benefits to 1 organization
I20221203000515 CO Practitioner - General SurgeryPractitioner - Vascular Surgery 5092816306 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60327871WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Jul 1, 2013 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Emergency Medicine CurrentSince Jun 17, 2019 Accepting new patients
Multicare Health System CurrentSince Jul 1, 2013 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Emergency Medicine CurrentSince Jun 17, 2019 Accepting new patients
Multicare Health System Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest Emergency Medicine Current Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Oct 1, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jun 17, 2019 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Oct 1, 2022 Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

2643 Patterson Rd
Ste 605
Grand Junction, CO 81506
Phone (970) 244-2482

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Interoperability endpoints

  • Direct secure messaging: cjohnson118304@direct.multicare.org

Organizations & group practices 9

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1184605347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-958-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVENUE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984314882",
            "telephone_number": "253-968-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHATT",
        "middle_name": "ALLAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WA",
            "license": "MD60327871",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J8003",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60327871",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "J8003",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "J8003",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.