Individual provider Active NPI

Cara Lee Johnson, DO

  • Geriatric Medicine (Family Medicine) Physician
  • Loveland, CO
National Provider Identifier
1508095332
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
8610A Issued in WY
Practice address
2000 Boise Ave
Loveland, CO 80538-5006
Phone
(307) 220-8388
NPI assigned
Jul 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X DR0065142 CO
Geriatric Medicine (Family Medicine) Physician 207QG0300X 006102 AZ
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X DR0065142 CO
Geriatric Medicine (Family Medicine) Physician 207QG0300X 8610A WY Primary

Addresses

Primary practice location

2000 Boise Ave
Loveland, CO 80538-5006

Mailing address

1801 16TH St
Greeley, CO 80631-5154
Phone (307) 220-8388

Other practice location 1

1801 16th St
Greeley, CO 80631-5154
Phone (307) 220-8388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20130805000827 WY Practitioner - Geriatric Medicine 8921245168 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006102AZMDGeriatric Medicine (Family Medicine) Physician
DR0065142COMDHospice and Palliative Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wyoming Family Medicine CurrentSince Sep 1, 2013 Accepting new patients
University of Wyoming Speech and Hearing Clinic CurrentSince Sep 1, 2013 Accepting new patients
University of Wyoming Family Medicine Past Accepting new patients

Locations

214 E 23rd St
Cheyenne, WY 82001
Phone (307) 324-2221

820 E 17th St
Cheyenne, WY 82001
Phone (307) 431-5055

Interoperability endpoints

  • Direct secure messaging: cjohnson11164@direct.crmcwy.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1508095332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315154",
            "telephone_number": "307-220-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 BOISE AVE",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805385006",
            "telephone_number": "307-220-8388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 16th St",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "806315154",
            "country_code": "US",
            "telephone_number": "307-220-8388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CARA",
        "middle_name": "LEE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2022-05-19",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CO",
            "license": "DR0065142",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "AZ",
            "license": "006102",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "CO",
            "license": "DR0065142",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "WY",
            "license": "8610A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.