Active NPI
Lansworth Johnson
- Physician Assistant
- Jackson, WY
National Provider Identifier
1609085794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 155
- Practice address
- 555 East Broadway
Jackson, WY 83001 - Phone
- (307) 733-3900
- Fax
- (307) 732-0925
- NPI assigned
- May 22, 2007
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 155 | WY | Primary |
Addresses
Primary practice location
555 East Broadway
Jackson, WY 83001
Mailing address
PO Box 10490
Jackson, WY 83002-0490
Phone (307) 733-3900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 155 | WY | MD | Marriage & Family Therapist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Jackson, WY
- NPI 1336221712
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1609085794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10490",
"city": "JACKSON",
"state": "WY",
"postal_code": "830020490",
"telephone_number": "307-733-3900",
"fax_number": "307-732-0925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 EAST BROADWAY",
"city": "JACKSON",
"state": "WY",
"postal_code": "83001",
"telephone_number": "307-733-3900",
"fax_number": "307-732-0925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "LANSWORTH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WY",
"license": "155",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.