Michael Wayne Johnson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD10807 Issued in OR

Practice address

21887 SW Sherwood Blvd Ste C
Sherwood, OR 97140-9412

Phone

(503) 625-7474

Fax

(503) 625-1688

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Legacy Meridian Park Hospital

  • Hospitalist Physician
  • Tualatin, OR
  • NPI 1023305034
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1649299173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21887 SW SHERWOOD BLVD STE C",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971409412",
            "telephone_number": "503-625-7474",
            "fax_number": "503-625-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21887 SW SHERWOOD BLVD STE C",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971409412",
            "telephone_number": "503-625-7474",
            "fax_number": "503-625-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD10807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Joseph James, PSY.D.
• Jansen Chiropractic Clinic PC
• Gary Jansen, D.C.
• Larry Edwin Raymond Jasper, PSYD
• Kortnie Johnson, SDH
• Michelle A Johnson, LMT
• Rue Johnson
• Scott G Johnson, AU.D.
• Sheila Johnson, LMT
• Deanna Joo, PHARMD

• Internal Medicine Physician in Sherwood, OR
• Providers in Sherwood, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.