Individual provider Active NPI

Gregory A Johnson, D.C.

  • Chiropractor
  • Williamsport, PA
National Provider Identifier
1528100799
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC001407L Issued in PA
Practice address
800 W 4TH St
Suite G-02
Williamsport, PA 17701-5895
Phone
(570) 323-8961
Fax
(570) 321-1493
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC001407L PA Primary

Addresses

Primary practice location

800 W 4TH St
Suite G-02
Williamsport, PA 17701-5895

Mailing address

800 W 4TH St
Suite G-02
Williamsport, PA 17701-5895
Phone (570) 323-8961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090107000556 PA Practitioner - Chiropractic 5890858468 Practice locations: Williamsport, PA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528100799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W 4TH ST",
            "address_2": "SUITE G-02",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177015895",
            "telephone_number": "570-323-8961",
            "fax_number": "570-321-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 4TH ST",
            "address_2": "SUITE G-02",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177015895",
            "telephone_number": "570-323-8961",
            "fax_number": "570-321-1493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GREGORY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC001407L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.