Individual provider Active NPI

George Gary Johnson, D.C.

  • Chiropractor
  • Sunnyvale, TX
National Provider Identifier
1215085634
Registry record updated Aug 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8510 Issued in TX
Practice address
270 S. Collins Road
Ste. 200
Sunnyvale, TX 75182-4625
Phone
(972) 226-4444
Fax
(972) 203-1914
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8510 TX Primary

Addresses

Primary practice location

270 S. Collins Road
Ste. 200
Sunnyvale, TX 75182-4625

Mailing address

270 S. Collins Road
Ste. 200
Sunnyvale, TX 75182-4625
Phone (972) 226-4444

Other identifiers 1

IdentifierTypeStateIssuer
150683401MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090924000492 TX Practitioner - Chiropractic 5890841365 Practice locations: Crandall, TX

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

108 S Main St
Crandall, TX 75114-2900
Phone (972) 472-3818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08510TXMDFamily Psychologist
8510TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kirashaven Holdings, Inc. Chiropractor Past Accepting new patients

Organizations & group practices 1

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250121600000",
    "number": "1215085634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 S. COLLINS ROAD",
            "address_2": "STE. 200",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "751824625",
            "telephone_number": "972-226-4444",
            "fax_number": "972-203-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 S. COLLINS ROAD",
            "address_2": "STE. 200",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "751824625",
            "telephone_number": "972-226-4444",
            "fax_number": "972-203-1914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GEORGE",
        "middle_name": "GARY",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2009-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "8510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150683401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.