Active NPI
Kent Goulding Johnson, RPH
- Pharmacist
- Canon City, CO
National Provider Identifier
1528360518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10006
- Practice address
- 1414 Main St
Canon City, CO 81212-3906 - Phone
- (719) 275-5221
- NPI assigned
- Nov 23, 2010
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 10006 | CO | Primary |
Addresses
Primary practice location
1414 Main St
Canon City, CO 81212-3906
Mailing address
11 Kestrel CT
Canon City, CO 81212-2777
Phone (719) 275-7739
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10006 | CO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290470400000",
"number": "1528360518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 KESTREL CT",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812122777",
"telephone_number": "719-275-7739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1414 MAIN ST",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812123906",
"telephone_number": "719-275-5221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KENT",
"middle_name": "GOULDING",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-23",
"last_updated": "2010-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "10006",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canon City, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.