J Kevin Johnson MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

J KEVIN JOHNSON MD PC

Practice address

1600 North Grand
Suite 520
Pueblo, CO 81003

Phone

(719) 542-3100

Fax

(719) 542-3100

NPI assigned

Aug 21, 2006

Last updated

Jun 18, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

J Kevin Johnson, MD

Title

Doctor

Phone

(719) 542-3100

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1376659805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 NORTH GRAND",
            "address_2": "SUITE 520",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81003",
            "telephone_number": "719-542-3100",
            "fax_number": "719-542-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 NORTH GRAND",
            "address_2": "SUITE 520",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81003",
            "telephone_number": "719-542-3100",
            "fax_number": "719-542-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J KEVIN JOHNSON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "719-542-3100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01365246",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD7190",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ufaq Ishtiaq
• Pamela Isley, NP
• Ivan Ivanov, PT
• Jennifer L. Iverson
• Pamela Jean Ivey, RN
• J. Valentine Cichon, MD PC
• Ryan D Jaarsma, PSY.D.
• Jace's Place Limited Liability Co.
• Carla Jean Jackson-Howard, ACNP-BC
• Brittany Oreon Jackson, MBA

• Internal Medicine Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Internal Medicine Physician in Colorado

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