NPIMap

Organization Active NPI

Sara L. Johnson, MD

  • Clinic/Center
  • Twin Falls, ID
National Provider Identifier
1346306974
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
M4188 Issued in ID
Legal business name
SARA L. JOHNSON, MD
Practice address
496 Shoup Ave W
Suite E
Twin Falls, ID 83301-5043
Phone
(208) 733-2885
Fax
(208) 734-3352
NPI assigned
Dec 28, 2006
Last updated
Jun 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Dr. Sara Johnson, M.D.NPI 1881601698
Title
Owner
Phone
(208) 733-2885

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X M4188 ID Primary

Addresses

Primary practice location

496 Shoup Ave W
Suite E
Twin Falls, ID 83301-5043

Mailing address

496 Shoup Ave W
Suite E
Twin Falls, ID 83301-5043
Phone (208) 733-2885

Other identifiers 2

IdentifierTypeStateIssuer
8H757OtherIDBLUE CROSS OF IDAHO
000010017978OtherIDREGENCE BLUE SHIELD OF ID

National Provider Directory

National Provider Directory

Locations

325 Martin St
Ste 3
Twin Falls, ID 83301
Phone (208) 733-2885

496 Shoup Ave W
Ste E
Twin Falls, ID 83301
Phone (208) 733-2885

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1346306974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 SHOUP AVE W",
            "address_2": "SUITE E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015043",
            "telephone_number": "208-733-2885",
            "fax_number": "208-734-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SHOUP AVE W",
            "address_2": "SUITE E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015043",
            "telephone_number": "208-733-2885",
            "fax_number": "208-734-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARA L. JOHNSON, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-733-2885",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "ID",
            "license": "M4188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "8H757",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF ID",
            "identifier": "000010017978",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.