Timothy David Johanson, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

51152 Issued in AZ

Practice address

1501 N. Campbell Ave.
Tucson, AZ 85724

Phone

(952) 920-9191

Fax

(952) 920-0232

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1578577441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 E. ELVIRA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857567124",
            "telephone_number": "520-626-0923",
            "fax_number": "520-626-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N. CAMPBELL AVE.",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85724",
            "telephone_number": "952-920-9191",
            "fax_number": "952-920-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSON",
        "first_name": "TIMOTHY",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "33782",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "51152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "1200632",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "496002500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "CP9020830013",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "47B40JO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megann Jobson, PA-C
• Caitlyn Jodon, MS, CF-SLP
• Allyssa Joe
• Leonard Joffe, MD
• Carleen Jogodka, P.T.
• Meghan Johansson, RDN
• John Bentley MD PC
• John C Titone PHD PC
• John C. Medlen, M.D., P.C.
• John Clement Biboa , D.O

• Pediatrics Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.