Individual provider Active NPI

Joshua Don Johnson

  • Physician Assistant
  • Loma Linda, CA
National Provider Identifier
1558885293
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
25240 Lawton Ave
Loma Linda, CA 92354-3541
Phone
(801) 643-2339
NPI assigned
Aug 2, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

25240 Lawton Ave
Loma Linda, CA 92354-3541

Mailing address

25240 Lawton Ave
Loma Linda, CA 92354-3541
Phone (801) 643-2339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180123003295 CA Practitioner - Physician Assistant 1658630470 Reassigns benefits to 1 organization
I20201119001550 ID Practitioner - Physician Assistant 1658630470 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
55076CAMDDentist
PA-1898IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jan 16, 2018 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jan 16, 2018 Accepting new patients
Adolpho Enterprise LLC. Past Accepting new patients

Locations

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

Interoperability endpoints

  • Direct secure messaging: jjohnson113137@direct.llu.edu

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1558885293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25240 LAWTON AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543541",
            "telephone_number": "801-643-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25240 LAWTON AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543541",
            "telephone_number": "801-643-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOSHUA",
        "middle_name": "DON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.