Courtney Rose Johnson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

00037773 Issued in WA

Practice address

3623 SW Alaska St, Suite 7
Seattle, WA 98126

Phone

(360) 440-8376

Fax

(360) 474-3927

NPI assigned

Aug 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Courtney Rose Williams Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 13, 2016 through Dec 13, 2026

Merit-based Incentive Payment System (MIPS)

Final score

40.82 of 100Reported as group

Quality

9.1

Promoting interoperability

100

Improvement activities

0

Cost

43.64

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Qliance Medical Group of Washington

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1417194317
  NPD (past)
• The Polyclinic PLLC

  • Durable Medical Equipment & Medical Supplies
  • Tacoma, WA
  • NPI 1831411487

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1497863005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3623 SW ALASKA ST STE 7",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981262732",
            "telephone_number": "206-278-3930",
            "fax_number": "360-474-3947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3623 SW ALASKA ST, SUITE 7",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98126",
            "telephone_number": "360-440-8376",
            "fax_number": "360-474-3927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "COURTNEY",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00037773",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "00037773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "176500",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8270597",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD",
            "identifier": "5319WI",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7094279",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "WILLIAMS",
            "middle_name": "ROSE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chloe Johnson
• Chris Douglas Johnson, PA-C
• Christopher D Johnson, O.D.
• Christopher S. Johnson, MA, AUD
• Claudia Graciela Johnson
• Curt K. Johnson
• Cynthia Bird Johnson, M.D.
• Cynthia M. Johnson, P.A.
• Cynthia Renee Johnson, LMP
• Cytauni Grae Johnson, AGNP-C

• Family Medicine Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.