David Johnson, M.D., P. a.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

M9086 Issued in ID

Legal business name

DAVID JOHNSON, M.D., P. A.

Practice address

775 Pole Line Rd W
Suite 213
Twin Falls, ID 83301-5814

Phone

(208) 814-8475

Fax

(208) 734-4177

NPI assigned

May 31, 2006

Organization subpart

No

Name

David A Johnson, M.D.NPI 1922035104

Title

Physician

Phone

(208) 814-7150

Organizations this organization is a member of, according to the National Provider Directory.

• St Luke'S Clinic LLC

  • Family Medicine Physician
  • Twin Falls, ID
  • NPI 1790718229

  Member Of

  NPD member

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David A Johnson, M.D.

  • Vascular Surgery Physician
  • Twin Falls, ID
  • NPI 1922035104

  Vascular Surgery

  NPD (past) Authorized official

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 9, 2013.

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362787200000",
    "number": "1467499418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 POLE LINE RD W",
            "address_2": "SUITE 213",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015814",
            "telephone_number": "208-814-8475",
            "fax_number": "208-734-4177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 POLE LINE RD W",
            "address_2": "SUITE 213",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015814",
            "telephone_number": "208-814-8475",
            "fax_number": "208-734-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID JOHNSON, M.D., P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2013-03-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "208-814-7150",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "ID",
            "license": "M9086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003760400",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "020051471",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Dalley, RDN, LD
• Dallin C. Young, D.D.D, P.a.
• Chet Dansie, CRNA
• Terry Darrington, OTL
• Stacy Davenport
• David R. Long D.C. P.a.
• Liberty Ann Davis, RPH
• Zachary Davis, PT, DPT
• Stephen Dayton, LSW
• Justin Moroni Dazley, M.D.

• All providers in Twin Falls, ID
• Vascular Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2013; 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.