Evelyn Johnson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

272340 Issued in AK

Practice address

542 4TH Ave
Ste. 234
Fairbanks, AK 99701-4714

Phone

(907) 456-4524

Fax

(907) 456-5524

NPI assigned

Mar 14, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1265565311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4016 SPRUCE ST APT 4",
            "city": "FT WAINWRIGHT",
            "state": "AK",
            "postal_code": "997031112",
            "telephone_number": "907-456-4524",
            "fax_number": "907-456-5524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 4TH AVE",
            "address_2": "STE. 234",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014714",
            "telephone_number": "907-456-4524",
            "fax_number": "907-456-5524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EVELYN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AK",
            "license": "272340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CM4322",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Johnson
• Daniel R Johnson, D.O.
• Dustin Johnson
• Erica Marie Johnson
• Essie Theresa Johnson, LPN
• Gregory Lee Johnson, D.D.S
• Hannah Johnson
• Hollie Ann Johnson
• Justin Johnson
• Katherine Elizabeth Johnson, M.D.

• Case Manager/Care Coordinator in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Case Manager/Care Coordinator in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.