Individual provider Active NPI

Harold Desmond Johnson, MEDICAL DOCTOR

  • Obstetrics & Gynecology Physician
  • Oregon City, OR
National Provider Identifier
1205965951
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD10451 Issued in OR
Practice address
1508 Division St
Ste 205
Oregon City, OR 97045-1582
Phone
(503) 657-1071
Fax
(503) 657-3321
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD10451 OR Primary

Addresses

Primary practice location

1508 Division St
Ste 205
Oregon City, OR 97045-1582

Mailing address

1508 Division St
Ste 205
Oregon City, OR 97045-1582
Phone (503) 657-1071

Other identifiers 1

IdentifierTypeStateIssuer
231514MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD10451ORMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Urology, LLC Past Accepting new patients
Women'S Healthcare Associates, LLC PastSince Jul 31, 1999 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1205965951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 DIVISION ST",
            "address_2": "STE 205",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451582",
            "telephone_number": "503-657-1071",
            "fax_number": "503-657-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 DIVISION ST",
            "address_2": "STE 205",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451582",
            "telephone_number": "503-657-1071",
            "fax_number": "503-657-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HAROLD",
        "middle_name": "DESMOND",
        "name_prefix": "Mr.",
        "credential": "MEDICAL DOCTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD10451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231514",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.