Raymon Tyler Johnson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC 30699 Issued in CA

Practice address

83 Via Pico PLZ
San Clemente, CA 92672-3998

Phone

(949) 436-6440

NPI assigned

Nov 6, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• R Tyler Johnson Chiropractic Professional Corporation

  • Clinic/Center
  • San Clemente, CA
  • NPI 1588083489
  Medicare reassignment Authorized official
• Michael L Kreutz Chiropractic Inc

  • Chiropractor
  • San Clemente, CA
  • NPI 1457651713
  NPD (past)
• Stephanie Glover Chiropractic Inc

  • Chiropractor
  • San Clemente, CA
  • NPI 1902500408
  NPD (past)

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1639359763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 VIA PICO PLZ",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723998",
            "telephone_number": "949-436-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 VIA PICO PLZ",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723998",
            "telephone_number": "949-436-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RAYMON",
        "middle_name": "TYLER",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-06",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC30699",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 30699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnson & Rollolazo, a Professional Corporation
• Eric Scott Johnson, DDS
• Evelyn M Johnson, DO
• James Robert Johnson, M.D.
• Martin Arthur Johnson, M.D.
• Dale R. Johnstone, D.D.S.
• Rima Danielle Jomaa, MA, MFT
• Jon Marashi, DDS, PC
• Cheyenne Jones
• Makenna Jean Jones

• Chiropractor in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.