Individual provider Active NPI

Ryan Christopher Johnson, MSN, NP-C

  • Family Nurse Practitioner
  • Salem, OR
National Provider Identifier
1316341472
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201503093NP-PP Issued in OR
Practice address
3750 Chemawa Rd NE
Salem, OR 97305-1119
Phone
(503) 304-7606
Fax
(503) 304-7673
NPI assigned
Oct 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP7384 AZ
Family Nurse Practitioner 363LF0000X 201503093NP-PP OR Primary

Addresses

Primary practice location

3750 Chemawa Rd NE
Salem, OR 97305-1119

Mailing address

3750 Chemawa Rd NE
Salem, OR 97305-1119
Phone (503) 304-7606

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
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP7384AZMDFamily Nurse Practitioner
201503093NP-PPORMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1316341472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 CHEMAWA RD NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051119",
            "telephone_number": "503-304-7606",
            "fax_number": "503-304-7673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 CHEMAWA RD NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051119",
            "telephone_number": "503-304-7606",
            "fax_number": "503-304-7673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RYAN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-20",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP7384",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201503093NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

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

Verify at the official NPI Registry.