Neil G. Johnson, M.D. Inc.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

G20232 Issued in CA

Legal business name

NEIL G. JOHNSON, M.D. INC.

Practice address

18300 US Highway 18
C/O St. Mary Medical Center
Apple Valley, CA 92307-2206

Phone

(909) 881-6427

Fax

(909) 887-8708

NPI assigned

May 24, 2007

Last updated

Mar 5, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Neil G Johnson, M.D.NPI 1740274380

Title

President

Phone

(909) 881-6427

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Neil Grant Johnson, M.D.

  • Neurological Surgery Physician
  • Apple Valley, CA
  • NPI 1740274380
  NPD (past) Authorized official

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1649481763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9160",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924270160",
            "telephone_number": "909-881-6427",
            "fax_number": "909-887-8708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 US HIGHWAY 18",
            "address_2": "C/O ST. MARY MEDICAL CENTER",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072206",
            "telephone_number": "909-881-6427",
            "fax_number": "909-887-8708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIL G. JOHNSON, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-881-6427",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "G20232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHIC/NCA",
            "identifier": "ZZZ13874Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "ZZZ13874Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0079600",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER #",
            "identifier": "ZZZ54436Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neurological Surgery Physician in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Neurological Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.