Joel a Johnson, M.D., P.C.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

4301057398 Issued in MI

Legal business name

JOEL A JOHNSON, M.D., P.C.

Practice address

1414 W Fair Ave
Ste 215
Marquette, MI 49855-2675

Phone

(906) 225-7701

Fax

(906) 225-7705

NPI assigned

Nov 29, 2005

Organization subpart

No

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

Authorized official

Name

Joel A Johnson, M.D.

Title

President

Phone

(906) 225-7701

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Upper Great Lakes Vascular, P.C Doing business as

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366425852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "STE 348",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-3964",
            "fax_number": "906-226-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "STE 215",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-7701",
            "fax_number": "906-225-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOEL A JOHNSON, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-225-7701",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MI",
            "license": "4301057398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "330E21025",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Upper Great Lakes Vascular, P.C",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hannah Rose York Jesme
• Brad Jezewski
• JJDM Management of Marquette
• JLK Therapy, LLC
• Jodi Coolman, LLC
• John G Kublin MD PC
• John Niemela
• Abigail Diane Johnson
• Abigale Johnson
• Cheri Johnson

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Marquette, MI
• Providers in Marquette, MI by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.