Individual provider Active NPI

Stephen M Johs, M.D.

  • Surgery Physician
  • Boulder, CO
National Provider Identifier
1639153273
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
28605 Issued in CO
Practice address
4743 Arapahoe Ave Ste 100
Boulder, CO 80303-1123
Phone
(303) 443-2123
Fax
(303) 443-9497
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 28605 CO Primary

Addresses

Primary practice location

4743 Arapahoe Ave Ste 100
Boulder, CO 80303-1123

Mailing address

PO Box 9049
Boulder, CO 80301-9049
Phone (303) 443-2123

Other practice location 1

80 Health Park Dr
Suite 100
Louisville, CO 80027-9584
Phone (303) 666-2630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28605COMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health Past Accepting new patients
Boulder Community Health Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1639153273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9049",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803019049",
            "telephone_number": "303-443-2123",
            "fax_number": "303-443-9497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4743 ARAPAHOE AVE STE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031123",
            "telephone_number": "303-443-2123",
            "fax_number": "303-443-9497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Health Park Dr",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "CO",
            "postal_code": "800279584",
            "country_code": "US",
            "telephone_number": "303-666-2630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHS",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "28605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.