Active NPI
Larry Hugh Johnson, M.D.
- Family Medicine Physician
- Bremerton, WA
National Provider Identifier
1275514911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00037208
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| E-4454 | AR | MD | Family Medicine Physician |
| 36892 | KY | MD | Family Medicine Physician |
| 2001-01071 | NC | MD | Family Medicine Physician |
| 2003-0111 | NM | MD | Family Medicine Physician |
| MD00037208 | WA | MD | Family 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.