Craig a. Johnson, M.D., PSC

Primary specialty

Hospice and Palliative Medicine (Obstetrics & Gynecology) PhysicianTaxonomy code 207VH0002X

License

KY23893 Issued in KY

Legal business name

CRAIG A. JOHNSON, M.D., PSC

Practice address

912 Wallace Ave
Suite 101
Leitchfield, KY 42754-2404

Phone

(270) 259-9316

Fax

(270) 259-6571

NPI assigned

Apr 10, 2007

Last updated

Aug 22, 2020By 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

Opal R Boone

Title

Practice Manager

Phone

(270) 259-9316

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447473392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 WALLACE AVE",
            "address_2": "SUITE 101",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427542404",
            "telephone_number": "270-259-9316",
            "fax_number": "270-259-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 WALLACE AVE",
            "address_2": "SUITE 101",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427542404",
            "telephone_number": "270-259-9316",
            "fax_number": "270-259-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIG A. JOHNSON, M.D., PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOONE",
        "authorized_official_first_name": "OPAL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "270-259-9316"
    },
    "taxonomies": [
        {
            "code": "207VH0002X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Hospice and Palliative Medicine",
            "state": "KY",
            "license": "KY23893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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.