Paul David Johenk, DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

20A4190 Issued in CA

Practice address

US Hwy 491 North
Shiprock, NM 87420

Phone

(505) 368-6401

Fax

(505) 368-6431

NPI assigned

Oct 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198627200000",
    "number": "1366430084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "874200160",
            "telephone_number": "505-368-6401",
            "fax_number": "505-368-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US HWY 491 NORTH",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "87420",
            "telephone_number": "505-368-6401",
            "fax_number": "505-368-6431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHENK",
        "first_name": "PAUL",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2007-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "20A4190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41639529",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B3824",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "696388",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Jensen, R.N.
• James G. Jepson, PHARMD
• Lawanda T Jim
• Lorenda A Joe, LADAC
• Rita Joe, C.AD, LADAC, CACIII,
• Delbert John, LADAC
• Susie A John, MD MPH
• Beverly Elaine Johnson, LMSW
• David Charles Johnson, LMSW
• June Johnson, LSAA

• Anesthesiology Physician in Shiprock, NM
• Providers in Shiprock, NM by specialty
• Anesthesiology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; 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.