Stephen Mackemer Johnson

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

DR0025637 Issued in CO

Practice address

1010 Three Springs Blvd
Durango, CO 81301

Phone

(303) 306-7783

Fax

(303) 306-7753

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Stephen Johnson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395360000000",
    "number": "1326134875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17752",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802170752",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 THREE SPRINGS BLVD",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "81301",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STEPHEN",
        "middle_name": "MACKEMER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2014-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR0025637",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR0025637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64607038",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K5526",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHEN",
            "last_name": "JOHNSON",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jay C Johnson, M.D.
• Jordan Johnson, AUD.
• Meghan B Johnson
• Michael Walter Johnson, M.D. & DDS
• Shera Michelle Johnson, MT
• Vaughn Andrew Johnson, DDS, MS
• Juilene Helen Johnston, D.C.
• Wayne Andrew Johnston, CRNA
• Jesse Jones, LPCC
• Shona Holmes Jones, NP

• Emergency Medicine Physician in Durango, CO
• Providers in Durango, CO by specialty
• Emergency Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; 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.