Individual provider Active NPI

Joshua K Johnson, RN

  • Certified Registered Nurse Anesthetist
  • Carbondale, IL
National Provider Identifier
1326222563
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209007006 Issued in IL
Practice address
405 W Jackson St
Carbondale, IL 62901-1462
Phone
(618) 549-0721
Fax
(618) 529-0529
NPI assigned
Dec 24, 2007
Last updated
Jun 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209007006 IL Primary
Registered Nurse 163W00000X 041292231 IL

Addresses

Primary practice location

405 W Jackson St
Carbondale, IL 62901-1462

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 549-0721

Other practice location 1

201 S 14th St
Herrin, IL 62948-3631
Phone (618) 942-2171 ext. 65137

Other practice location 2

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-3156 ext. 65137

Other practice location 3

2601 W Main St
Carbondale, IL 62901-1031
Phone (618) 351-7300

Other identifiers 2

IdentifierTypeStateIssuer
2005017522OtherMORN LICENSE
214881OtherILMULTISPECIALTY GROUP PTAN

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address jjohnson14059@sih.direct-ci.com
Direct Messaging Address jjohnson14059@sih.direct-ci.com
Direct Messaging Address jjohnson14059@sih.direct-ci.com
Direct Messaging Address jjohnson14059@sih.direct-ci.com

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
Certified Registered Nurse, Registered Nurse

State licenses

LicenseStateTypeSpecialty
041292231ILMDRegistered Nurse
209007006ILMDCertified Registered Nurse Anesthetist

Interoperability endpoints

  • Direct secure messaging: jjohnson14059@sih.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1326222563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-549-0721",
            "fax_number": "618-529-0529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W JACKSON ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011462",
            "telephone_number": "618-549-0721",
            "fax_number": "618-529-0529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 S 14th St",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483631",
            "country_code": "US",
            "telephone_number": "618-942-2171 x65137",
            "fax_number": "618-351-4919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 S Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Murphysboro",
            "state": "IL",
            "postal_code": "629663333",
            "country_code": "US",
            "telephone_number": "618-684-3156 x65137",
            "fax_number": "618-529-0529",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2601 W Main St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011031",
            "country_code": "US",
            "telephone_number": "618-351-7300",
            "fax_number": "618-457-7890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOSHUA",
        "middle_name": "K",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-24",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209007006",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041292231",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "2005017522",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTISPECIALTY GROUP PTAN",
            "identifier": "214881",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjohnson14059@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "405 W Jackson Street",
            "address_2": "SIH Medical Group Anesthesiology",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjohnson14059@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "201 S 14th Street",
            "address_2": "SIH Medical Group Anesthesiology",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjohnson14059@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2601 W Main Street",
            "address_2": "Southern Illinois Medical Services NFP",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjohnson14059@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2 South Hospital Drive",
            "address_2": "SIH Medical Group Anesthesia",
            "city": "Murphysboro",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; 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.