J.R. Johnson, M.D., Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

G69427 Issued in CA

Legal business name

J.R. JOHNSON, M.D., INC

Practice address

901 Calle Amanecer
Ste 100
San Clemente, CA 92673

Phone

(949) 218-1470

Fax

(949) 218-1471

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. James Robert Johnson, M.D.NPI 1093864423

Title

President

Phone

(949) 218-1470

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Robert Johnson, M.D.

  • Family Medicine Physician
  • San Clemente, CA
  • NPI 1093864423
  Medicare reassignment Authorized official
• Nazema Gosla, PA

  • Physician Assistant
  • Tustin, CA
  • NPI 1659493674
  Medicare reassignment

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184836066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 CALLE AMANECER",
            "address_2": "STE 100",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "92673",
            "telephone_number": "949-218-1470",
            "fax_number": "949-218-1471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 CALLE AMANECER",
            "address_2": "STE 100",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "92673",
            "telephone_number": "949-218-1470",
            "fax_number": "949-218-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J.R. JOHNSON, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-218-1470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "G69427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Immersive Wellness Centers, LLC
• Inchel Yeam
• Intent Performance Physical Therapy
• International Awareness Integration Institute
• Homayon Iraninezhad, DO
• Yasmina Jabri, BCBA
• Jaesung Kim DMD Inc
• Carolyn Kay Jahan, MFT
• Colin Xephary Jairam, MD
• James E Keany, MD, Apmc

• Primary Care Clinic/Center in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.