Individual provider Active NPI

Ashley Johnson, LA

  • Specialist
  • Corvallis, OR
National Provider Identifier
1346697489
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
COS- FT- 10119169 Issued in OR
Practice address
996 NW Circle Blvd Ste 103
Corvallis, OR 97330-1485
Phone
(541) 768-4370
Fax
(541) 768-9790
NPI assigned
May 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X COS- FT- 10119169 OR Primary

Addresses

Primary practice location

996 NW Circle Blvd Ste 103
Corvallis, OR 97330-1485

Mailing address

996 NW Circle Blvd Ste 103
Corvallis, OR 97330-1485
Phone (541) 768-4370

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
COS- FT- 10119169ORMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1346697489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "996 NW CIRCLE BLVD STE 103",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973301485",
            "telephone_number": "541-768-4370",
            "fax_number": "541-768-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "996 NW CIRCLE BLVD STE 103",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973301485",
            "telephone_number": "541-768-4370",
            "fax_number": "541-768-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ASHLEY",
        "credential": "LA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "COS- FT- 10119169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.