Lynn Robert Johnson, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

E1406 Issued in CA

Practice address

1205 N Hunter St
Stockton, CA 95202-1409

Phone

(209) 464-7367

Fax

(209) 464-1801

NPI assigned

Feb 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Associated Podiatry Group

  • Foot & Ankle Surgery Podiatrist
  • Modesto, CA
  • NPI 1063550622
  NPD (past) Authorized official

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302134400000",
    "number": "1619949187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 N HUNTER ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021409",
            "telephone_number": "209-464-7367",
            "fax_number": "209-464-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 N HUNTER ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021409",
            "telephone_number": "209-464-7367",
            "fax_number": "209-464-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LYNN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2011-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E1406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ73253Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "E1406",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kira Marie Johnson
• Kirsten Faith Johnson
• Kurt Johnson, M.D.
• Lantrice Johnson
• Lauren Johnson, RNFA
• Megan Christine Johnson
• Mika Donai Johnson
• Monica Johnson
• Natalie Jinia Johnson
• Niesha Johnson

• Podiatrist in Stockton, CA
• Providers in Stockton, CA by specialty
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; 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.