Rodger A Johnson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

000038111 Issued in OR

Practice address

342 Fairview St
Silverton, OR 97381

Phone

(503) 873-1500

NPI assigned

Jun 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1669412581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5319 SW WESTGATE DR",
            "address_2": "#241",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212432",
            "telephone_number": "503-297-7233",
            "fax_number": "503-297-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 FAIRVIEW ST",
            "city": "SILVERTON",
            "state": "OR",
            "postal_code": "97381",
            "telephone_number": "503-873-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RODGER",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "000038111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "246744",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BCBSO",
            "identifier": "807251003",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Waldemar Jensen, M.D.
• Jhso Corporation
• Jhso Corporation
• Bradley McNeil Johnson
• Rae S. Johnson, PA-C
• Coleen Ju, FNP
• Barbara Linn Keller, MD
• Helen Pearl Kelley, M.ED.
• Lindsay Kinman, CPM, LDM
• Kevin Knutson

• Certified Registered Nurse Anesthetist in Silverton, OR
• Providers in Silverton, OR by specialty
• Certified Registered Nurse Anesthetist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.