J Michael Johnson, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

B190 Issued in NV

Practice address

1675 Lakeside Dr Ste 103
Reno, NV 89509-3421

Phone

(775) 322-5704

Fax

(775) 322-8297

NPI assigned

Dec 15, 2006

Last updated

Jun 30, 2022By the provider in NPPES

Sex

Male

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

Networks

• UT PPO D-SNP
• UT PPO

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1265594154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 LAKESIDE DR STE 103",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895093421",
            "telephone_number": "775-322-5704",
            "fax_number": "775-322-8297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 LAKESIDE DR STE 103",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895093421",
            "telephone_number": "775-322-5704",
            "fax_number": "775-322-8297"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1665 Lakeside Dr",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "89509",
            "country_code": "US",
            "telephone_number": "775-322-5704",
            "fax_number": "775-322-8297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "J",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NV",
            "license": "B190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek Lyle Johnson, DMD
• Gary Johnson, M.D.
• Gary M Johnson, PA-C
• Heidi Marie Johnson, MD
• Idris Johnson
• Janet Johnson
• Jasmine Lynn Johnson
• Jeanine Kay Johnson, OTR/L
• Jeffrey Alan Johnson, OTR/L
• Jennifer Johnson

• Chiropractor in Reno, NV
• Providers in Reno, NV by specialty
• Chiropractor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.