Johnson Chiropractic Clinic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIRO 584 Issued in ID

Legal business name

JOHNSON CHIROPRACTIC CLINIC

Practice address

600 N Lincoln Ave
Jerome, ID 83338

Phone

(208) 324-3730

Fax

(208) 324-5512

NPI assigned

Oct 11, 2006

Last updated

Oct 22, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Laura Marie Johnson-Stevenson, BS DC CCEPNPI 1649357351

Title

President

Phone

(208) 324-3730

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Johnson Chiropractic Clinic Former legal business name

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Laura Marie Johnson Stevenson, BS DC CCEP

  • Chiropractor
  • Jerome, ID
  • NPI 1649357351
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1316035512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N LINCOLN AVE",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "83338",
            "telephone_number": "208-324-3730",
            "fax_number": "208-324-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N LINCOLN AVE",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "83338",
            "telephone_number": "208-324-3730",
            "fax_number": "208-324-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON-STEVENSON",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-324-3730",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "BS DC CCEP"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIRO 584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IDAHO",
            "identifier": "10019692",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "8N046",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johnson Chiropractic Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Troy M Jackman, PHARMD
• Tonya Lynn Jepson, LPC
• Jerome Chiropractic Clinic PLLC
• Jerome Family Chiropractic
• Jerome Toothtown PLLC
• Laura Marie Johnson Stevenson, BS DC CCEP
• Brian Lee Johnson, M.D.
• Elizabeth Jo Johnson, M.D.
• Logan Reed Jones, DO
• K2Red LLC (Jerome Drug)

• Chiropractor in Jerome, ID
• Providers in Jerome, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.