Jonathan Johnson

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

24 Airport Rd
West Lebanon, NH 03784-1663

Phone

(603) 298-6617

NPI assigned

Feb 14, 2012

Reactivated

Jan 10, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Patriot Urgent Care Professionals PCGroup PAC ID 8820248784, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Patriot Urgent Care Professionals, PC

  • Urgent Care Clinic/Center
  • Waltham, MA
  • NPI 1417205105
  Medicare reassignment Care Compare group
• Steward Medical Group, Inc

  • Specialist
  • Watertown, MA
  • NPI 1629398219
  Medicare reassignment NPD
• Patriot Urgent Care Professionals PC

  • Urgent Care Clinic/Center
  • Cambridge, MA
  • NPI 1245123587
  NPD
• Patriot Urgent Care Professionals, PC

  • Urgent Care Clinic/Center
  • Burlington, MA
  • NPI 1598195968
  NPD
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495
  NPD

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1225301757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 WATERSTON AVE",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021703432",
            "telephone_number": "617-842-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 AIRPORT RD",
            "city": "WEST LEBANON",
            "state": "NH",
            "postal_code": "037841663",
            "telephone_number": "603-298-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JONATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-14",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "deactivation_date": "2019-12-30",
        "reactivation_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Mary Hooper
• Shaunna Marie Houle, DPT
• Ellie Marie Hutchins, OT
• Robert Hutchinson III, BA
• Jebediah S Christy DDS - West Lebanon PC
• Matthew Jones, PHARM.D.
• Rebecca Watson Jones, LPN
• Christopher Sean Jordan
• Zehra Merve Kaya, PHD, MA
• Keith Christopher Kealey, DMD

• Student in an Organized Health Care Education/Training Program in West Lebanon, NH
• Providers in West Lebanon, NH by specialty
• Student in an Organized Health Care Education/Training Program in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; 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.