Individual provider Active NPI

Marian Elaine Johnston, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Mount Vernon, WA
National Provider Identifier
1437107059
Registry record updated Apr 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
MD00035789 Issued in WA
Practice address
125 N 18TH St
Suite # B
Mount Vernon, WA 98273-3902
Phone
(360) 336-0123
Fax
(360) 336-0126
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X MD00035789 WA Primary

Addresses

Primary practice location

125 N 18TH St
Suite # B
Mount Vernon, WA 98273-3902

Mailing address

125 N 18TH St
Suite # B
Mount Vernon, WA 98273-3902
Phone (360) 336-0123

Other identifiers 1

IdentifierTypeStateIssuer
8247710MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040429001031 WA Practitioner - AnesthesiologyPractitioner - Addiction MedicinePractitioner - Interventional Pain ManagementPractitioner - Pain ManagementPractitioner - General Practice 1557355252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Addiction Medicine, General Practice, Interventional Pain Management, Pain Management
Education
Baylor College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

816 E Fairhaven Ave
Burlington, WA 98233-1917
Phone (360) 336-0123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Comprehensive Pain Consultants Inc P S Pain Medicine Current Accepting new patients

Locations

125 N 18th St
Ste B
Mount Vernon, WA 98273
Phone (360) 336-0123

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1437107059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N 18TH ST",
            "address_2": "SUITE # B",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982733902",
            "telephone_number": "360-336-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N 18TH ST",
            "address_2": "SUITE # B",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982733902",
            "telephone_number": "360-336-0123",
            "fax_number": "360-336-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "MARIAN",
        "middle_name": "ELAINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WA",
            "license": "MD00035789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8247710",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.