Active NPI
Ernest E Johnson, MD
- Otolaryngology Physician
- Sacramento, CA
National Provider Identifier
1285637967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- C19668
- Practice address
- 1111 Exposition Blvd
BLDG 700
Sacramento, CA 95815-4300 - Phone
- (916) 736-3399
- Fax
- (916) 233-4171
- NPI assigned
- May 24, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | C19668 | CA | Primary |
Addresses
Primary practice location
1111 Exposition Blvd
BLDG 700
Sacramento, CA 95815-4300
Mailing address
1111 Exposition Blvd
BLDG 700
Sacramento, CA 95815-4300
Phone (916) 736-3399
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040003539 | Other | CA | RR MEDICARE PIN |
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 |
|---|---|---|---|
| 19668 | CA | MD | Dental Hygienist |
| C19668 | CA | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502409600000",
"number": "1285637967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 EXPOSITION BLVD",
"address_2": "BLDG 700",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958154300",
"telephone_number": "916-736-3399",
"fax_number": "916-233-4171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 EXPOSITION BLVD",
"address_2": "BLDG 700",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958154300",
"telephone_number": "916-736-3399",
"fax_number": "916-233-4171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ERNEST",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-24",
"last_updated": "2017-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "CA",
"license": "C19668",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE PIN",
"identifier": "040003539",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.