Robert L Johnson, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

OP00001376 Issued in WA

Practice address

77 Wainwright Dr
Walla Walla, WA 99362-3975

Phone

(509) 525-5200

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

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.

• Pueblo Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Pueblo, CO
  • NPI 1770529950
  Medicare reassignment NPD
• Pueblo Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Pueblo, CO
  • NPI 1952071219
  NPD
• Behavioral Health Resources

  • Community/Behavioral Health Agency
  • Elma, WA
  • NPI 1306918750
  NPD (past)
• Palouse Counseling Service, PLLC

  • Clinical Social Worker
  • Walla Walla, WA
  • NPI 1699974113
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1366410425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 WAINWRIGHT DR",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993623975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 WAINWRIGHT DR",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993623975",
            "telephone_number": "509-525-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROBERT",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "OP00001376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dwight Layne Johnson, D.M.D., M.S.
• Jeffrey A Johnson, LCPO
• Kayla Brooke Johnson, LMT
• Robert Johnson, MD00041003
• Robert Arnold Johnson, M.D.
• Johnston Chiropractic LLC
• Ricky J Johnston, D.C.
• Glenda Jolliffe, MSW
• Jonathan M. Wainwright Memorial VA Medical Center
• Jonathan W. Gantz, DDS PLLC

• Psychiatry Physician in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.