Kathryn Mandelbaum Johnson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3470 Issued in CO

Practice address

2575 Spruce St
Boulder, CO 80302-3806

Phone

(303) 449-3594

Fax

(303) 449-3112

NPI assigned

Oct 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Boulder Community Health

  • Medical Specialty Clinic/Center
  • Boulder, CO
  • NPI 1407685498
  NPD (past)
• Boulder Community Health

  • Adult Mental Health Clinic/Center
  • Boulder, CO
  • NPI 1568121622
  NPD (past)
• Boulder Community Health

  • Multi-Specialty Clinic/Center
  • Boulder, CO
  • NPI 1609822030
  NPD (past)
• Cchmd Corp

  • Gynecology Physician
  • Boulder, CO
  • NPI 1497925986
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1205911328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 MAXWELL AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043972",
            "telephone_number": "303-544-5783",
            "fax_number": "303-441-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 SPRUCE ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803023806",
            "telephone_number": "303-449-3594",
            "fax_number": "303-449-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHRYN",
        "middle_name": "MANDELBAUM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "3470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harold L Johnson, MD
• Jennifer Myia Johnson, M.D.
• Jessica Johnson, RMT
• Joshua Johnson
• Karin Chandler Johnson, LPC
• Kelly Leader Johnson, PHARM. D.
• Kimberly Michelle Johnson, LPC
• Lara C Johnson, DPT
• Linda Lea Johnson, WHNP, M.S.N.
• Lyn Karol Johnson, M.A

• Medical Physician Assistant in Boulder, CO
• Providers in Boulder, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.