Joseph Kevin Johnson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

36524 Issued in CO

Practice address

999 S Fairmont Ave Ste 130
Lodi, CA 95240-5141

Phone

(209) 366-2001

Fax

(209) 366-2024

NPI assigned

Nov 19, 2007

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 4

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Internal Medicine

Education

Denver College of Medicine - NLG, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Home Care Services Home health agency, Lodi, CA, CCN 057278
• Memorial Medical Center Hospital, Modesto, CA, CCN 050557
• Sutter Amador Hospital Hospital, Jackson, CA, CCN 050014
• Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108
• Adventist Health Lodi Memorial Hospital, Lodi, CA, CCN 050336

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjohnson392992@hisp.ehr.sutterhealth.org

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.

• Sutter Valley Medical Foundation

  dba Sutter Gould Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Lodi Memorial Hospital Association, Inc

  dba Lodi Memorial Community Clinic - Iris

  • Primary Care Clinic/Center
  • Lodi, CA
  • NPI 1861649352
  Medicare reassignment NPD
• Lodi Memorial Hospital Association Inc

  dba Lodi Memorial Primary Care Clinic

  • Primary Care Clinic/Center
  • Lodi, CA
  • NPI 1306855523
  NPD
• Lodi Memorial Hospital Association Inc

  dba Lodi Memorial Hospital

  • General Acute Care Hospital
  • Lodi, CA
  • NPI 1316938301
  NPD
• Sutter Valley Medical Foundation

  • Durable Medical Equipment & Medical Supplies
  • Tracy, CA
  • NPI 1720930712
  NPD
• Sutter Valley Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1952327256

  Internal Medicine

  NPD
• Andersen Family Chiropractic PC

  • Chiropractor
  • York, PA
  • NPI 1538219878
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lodi Memorial Hospital Association Inc

  dba Lodi Memorial Hospital

  • General Acute Care Hospital
  • Lodi, CA
  • NPI 1316938301
  Care Compare affiliation
• Sutter Valley Hospitals

  dba Sutter Amador Hospital

  • General Acute Care Hospital
  • Jackson, CA
  • NPI 1447494323
  Care Compare affiliation
• Sutter Valley Hospitals

  dba Memorial Medical Center

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1699129601
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  Care Compare affiliation
• Western Health Resources

  dba Adventist Health Home Care Services

  • Home Health Agency
  • Lodi, CA
  • NPI 1770042103
  Care Compare affiliation

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1194906107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 S FAIRMONT AVE STE 130",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405141",
            "telephone_number": "209-366-2001",
            "fax_number": "209-366-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOSEPH",
        "middle_name": "KEVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-19",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "36524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01365246",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "841541697",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "841541697",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "DD7190",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Kiraly MD (Delta- Sierra Hematology & Oncology)
• John Lu DDS PC (Bella Terra Dental)
• Alexandria Johnson, LVN
• Amanda Johnson, OTR/L
• Jacqualine Tia Johnson
• Ross M Johnson, DDS
• Selena Marie Johnson
• Kimberly Lynn Jones, P.T. ASSISTANT
• Stacey Ann Jones
• Jeff Jordan

• Internal Medicine Physician in Lodi, CA
• Providers in Lodi, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.