Active NPI
Dan Johnston
- Surgical Assistant
- Marinette, WI
National Provider Identifier
1447657333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- Practice address
- 3117 Shore Dr
Marinette, WI 54143-4293 - Phone
- (715) 732-8200
- NPI assigned
- Nov 20, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | Primary |
Addresses
Primary practice location
3117 Shore Dr
Marinette, WI 54143-4293
Mailing address
164 N Broadway
Green Bay, WI 54303-2728
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baycare Clinic LLP | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Green Bay, WI
- NPI 1588609648
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416441600000",
"number": "1447657333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "164 N BROADWAY",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543032728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3117 SHORE DR",
"city": "MARINETTE",
"state": "WI",
"postal_code": "541434293",
"telephone_number": "715-732-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "DAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-20",
"last_updated": "2014-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marinette, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.