Individual provider Active NPI

Larry Hugh Johnson, M.D.

  • Family Medicine Physician
  • Bremerton, WA
National Provider Identifier
1275514911
Registry record updated Aug 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00037208 Issued in WA
Practice address
7643 Oak Park PL NW
Bremerton, WA 98311-9175
Phone
(360) 692-2399
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2008

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00037208 WA Primary
Family Medicine Physician 207Q00000X 2001-01071 NC
Family Medicine Physician 207Q00000X 35-04-0609-J OH
Family Medicine Physician 207Q00000X 2003-0111 NM
Family Medicine Physician 207Q00000X 36892 KY
Family Medicine Physician 207Q00000X E-4454 AR

Addresses

Primary practice location

7643 Oak Park PL NW
Bremerton, WA 98311-9175

Mailing address

7643 Oak Park PL NW
Bremerton, WA 98311-9175
Phone (360) 692-2399

Other names 1

  • Larry H. Johnson Other name

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
E-4454ARMDFamily Medicine Physician
36892KYMDFamily Medicine Physician
2001-01071NCMDFamily Medicine Physician
2003-0111NMMDFamily Medicine Physician
MD00037208WAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218412800000",
    "number": "1275514911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7643 OAK PARK PL NW",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983119175",
            "telephone_number": "360-692-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7643 OAK PARK PL NW",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983119175",
            "telephone_number": "360-692-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LARRY",
        "middle_name": "HUGH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2008-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00037208",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2001-01071",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-04-0609-J",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "2003-0111",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "36892",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-4454",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARRY",
            "last_name": "JOHNSON",
            "middle_name": "H.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; 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.