Mitchell C Johnson, DO

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

5151 Issued in SD

Practice address

810 E 23Rd St
Sioux Falls, SD 57105-2135

Phone

(605) 331-5890

Fax

(605) 336-3974

NPI assigned

Jul 12, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

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.

• Avera McKennan

  • Diagnostic Radiology Physician
  • Sioux Falls, SD
  • NPI 1053680678
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200873600000",
    "number": "1275568693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5116",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175116",
            "telephone_number": "605-331-5890",
            "fax_number": "605-336-3974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 E 23RD ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571052135",
            "telephone_number": "605-331-5890",
            "fax_number": "605-336-3974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MITCHELL",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SD",
            "license": "5151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6402150",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00028184",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark W Johnson, MD
• Mary Beth Johnson, CNP
• Matthew Scott Johnson, M.D.
• Melanie Marie Johnson, CNP
• Michael M Johnson, MD
• Nancy Ann Johnson, PHD
• Nichole Johnson
• Nicole Theresa Johnson, CNM
• Peter David Johnson, MD
• Rachel Kay Johnson

• Orthopaedic Surgery Physician in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Orthopaedic Surgery Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.