Kristofer K Johnson, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA60049525 Issued in WA

Practice address

12606 E Mission Ave
Spokane Valley, WA 99216-3421

Phone

(509) 924-6650

NPI assigned

Oct 7, 2008

Last updated

Mar 10, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Association of SpokaneGroup PAC ID 9638063217, 222 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristofer.johnson.1@11411.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
  • NPI 1326005851
  Medicare reassignment Care Compare group NPD (past)
• Multicare Health System

  dba Multicare Neurological Surgery

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment
• Spokane Emergency Care Physicians PLLC

  • Emergency Medicine Physician
  • Spokane, WA
  • NPI 1912564055
  Medicare reassignment
• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
  • NPI 1417731951
  NPD
• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
  • NPI 1679363592
  NPD
• Multicare Health System

  dba MultiCare Deaconess Retail Pharmacy

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  dba Kent MultiCare Clinic

  • Family Medicine Physician
  • Kent, WA
  • NPI 1811949928

  Physician Assistant

  NPD
• Community Health Association of Spokane

  dba Perry Street Clinic

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
  • NPI 1770972754
  NPD (past)

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1548411770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 758701",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212758701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12606 E MISSION AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992163421",
            "telephone_number": "509-924-6650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 W 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992014503",
            "country_code": "US",
            "telephone_number": "509-444-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KRISTOFER",
        "middle_name": "K",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-07",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60049525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA60049525",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremiah Brian Johnson, LMT
• Jody Leigh Johnson, LMHC
• Jordan Anne Johnson, MS, RD, CD
• Judy Renee Johnson, SLPA
• Kendra E Johnson, ARNP
• Lauren Johnson
• Lori Ann Johnson, BS
• Lynn Marie Johnson, RN
• Mary Ann Zaccaria Johnson, P.T.
• Megan Alyse Johnson, DPT

• Medical Physician Assistant in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; 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.
• 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.