Active NPI
Oliver Lawernce Johnston, MD
- Urology Physician
- Allegan, MI
National Provider Identifier
1639320955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 4301036842
- Practice address
- 551 Linn St
Suite 20
Allegan, MI 49010-1595 - Phone
- (269) 686-5888
- Fax
- (269) 686-5865
- NPI assigned
- Oct 6, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 4301036842 | MI | Primary |
Addresses
Primary practice location
551 Linn St
Suite 20
Allegan, MI 49010-1595
Mailing address
551 Linn St
Suite #20
Allegan, MI 49010-1595
Phone (268) 686-5888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301036842 | MI | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229558400000",
"number": "1639320955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "551 LINN ST",
"address_2": "SUITE #20",
"city": "ALLEGAN",
"state": "MI",
"postal_code": "490101595",
"telephone_number": "268-686-5888",
"fax_number": "269-686-5865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "551 LINN ST",
"address_2": "SUITE 20",
"city": "ALLEGAN",
"state": "MI",
"postal_code": "490101595",
"telephone_number": "269-686-5888",
"fax_number": "269-686-5865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "OLIVER",
"middle_name": "LAWERNCE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-10-06",
"last_updated": "2008-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "MI",
"license": "4301036842",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allegan, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2008; 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.