Active NPI
Robert John Johnson, M.D.
- Family Medicine Physician
- Eau Claire, WI
National Provider Identifier
1336156132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 46168
- Practice address
- 2809 E Hamilton Ave # 107
Eau Claire, WI 54701-6863 - Phone
- (715) 834-1555
- Fax
- (715) 835-0263
- NPI assigned
- Aug 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 46168 | WI | Primary |
Addresses
Primary practice location
2809 E Hamilton Ave # 107
Eau Claire, WI 54701-6863
Mailing address
2809 E Hamilton Ave # 107
Eau Claire, WI 54701-6863
Phone (715) 834-1555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00468921 | Other | WI | MEDICARE RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46168 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sauk Prairie Healthcare Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Prairie Du Sac, WI
- NPI 1205975380
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400198400000",
"number": "1336156132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2809 E HAMILTON AVE # 107",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547016863",
"telephone_number": "715-834-1555",
"fax_number": "715-835-0263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2809 E HAMILTON AVE # 107",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547016863",
"telephone_number": "715-834-1555",
"fax_number": "715-835-0263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ROBERT",
"middle_name": "JOHN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-02",
"last_updated": "2014-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "46168",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00468921",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eau Claire, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; 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.