Theodore Lawrence Johnson, D.C.

Primary specialty

Internist ChiropractorTaxonomy code 111NI0900X

License

0038006656 Issued in IL

Practice address

200 E Roosevelt Rd
Lombard, IL 60148-4539

Phone

(630) 889-6513

Fax

(630) 889-6800

NPI assigned

Jan 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: theodore.johnson.1@11209.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/11209/brand/1/csg/1/fhir/r4

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.

• National University of Health Sciences

  • Chiropractor
  • Lombard, IL
  • NPI 1316079775
  NPD (past)
• Sport & Spine Rehab Institute

  • Chiropractor
  • Lombard, IL
  • NPI 1982952552
  NPD (past)

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461888000000",
    "number": "1194703751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E ROOSEVELT RD",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484539",
            "telephone_number": "630-889-6513",
            "fax_number": "630-889-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E ROOSEVELT RD",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484539",
            "telephone_number": "630-889-6513",
            "fax_number": "630-889-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "THEODORE",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2016-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NI0900X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Internist",
            "state": "IL",
            "license": "0038006656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENCE NUMB",
            "identifier": "0038006656",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sabaa Salim Joad, M.D.
• John Comersouski PT PC
• John Michael Quinn & Associates
• Daniella Johnson
• Lynn M Johnson, LCPC
• Carie Johnstone, LCSW
• Chevon Jones
• Pamela Jones, RN
• Tyler Jones
• Tyron Jones, OTD

• Internist Chiropractor in Lombard, IL
• Providers in Lombard, IL by specialty
• Internist Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; 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.