Samuel Elan Johnson, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

20A6457 Issued in CA

Practice address

3 Medical Plaza Dr
Suite 140
Roseville, CA 95661-3087

Phone

(916) 865-1400

NPI assigned

Mar 19, 2007

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 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment NPD
• Sutter Valley Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986
  Medicare reassignment NPD
• Cep America - California

  • Emergency Medicine Physician
  • Auburn, CA
  • NPI 1700184819
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Active Life Wound Center a Professional Medical Corporation

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1396553616
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1326162991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MEDICAL PLAZA DR",
            "address_2": "SUITE 140",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613087",
            "telephone_number": "916-865-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SAMUEL",
        "middle_name": "ELAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A6457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSTEOPATHIC MEDICAL LIC.",
            "identifier": "20A6457",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsey Baker Johnson
• Kimberly Doris Johnson, LCSW
• Melanie Johnson, M.S.
• Melissa Ann Johnson, M.D.
• Rebecca Johnson, M.S.
• Scott S. Johnson, MD
• Tracey J Johnson, NP
• Alyssa Virginia Johnston, NP
• Jon James Johnston, D.O
• Kent W. Jolly, MD

• Emergency Medicine Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.