Craig Joel Johnson, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

29092 Issued in WI

Practice address

214 Elkhorn Rd
Williams Bay, WI 53191-9514

Phone

(262) 245-2600

Fax

(262) 245-6600

NPI assigned

Feb 27, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northland Neurology S.C.

  • Neurology Physician
  • Williams Bay, WI
  • NPI 1912034026
  Authorized official Same address or phone

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1184751349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 358",
            "city": "WILLIAMS BAY",
            "state": "WI",
            "postal_code": "531910358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 ELKHORN RD",
            "city": "WILLIAMS BAY",
            "state": "WI",
            "postal_code": "531919514",
            "telephone_number": "262-245-2600",
            "fax_number": "262-245-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CRAIG",
        "middle_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "29092",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31398400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morgan Gagas, MS, LPC
• Christine A Hanson, PHD
• Dinah Harner, RD
• Helm Therapy Services, LLC
• John Larry Jansky, PHD
• Mitchell Steven Johnson
• Susan Mary Johnson, RN BSN
• Kingme Inc
• Laura L. Kleber, OT
• Sue McConnell, APSW

• Neurology Physician in Williams Bay, WI
• Providers in Williams Bay, WI by specialty
• Neurology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.