Graham Kyle Johnson, D.O

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

20A12961 Issued in CA

Practice address

3061 Fillmore St
San Francisco, CA 94123-4009

Phone

(415) 292-3440

Fax

(415) 561-0244

NPI assigned

Jul 7, 2012

Last updated

Mar 26, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Torrico Medical Group Inc

  dba Consilient Interventional Clinicians

  • Psychiatry Physician
  • Santa Rosa, CA
  • NPI 1033926480
  Medicare reassignment NPD

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

{
    "created_epoch": "1341619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1669737557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954",
            "telephone_number": "916-576-7900",
            "fax_number": "916-285-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3061 FILLMORE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941234009",
            "telephone_number": "415-292-3440",
            "fax_number": "415-561-0244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2019 Webster St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941152329",
            "country_code": "US",
            "telephone_number": "415-366-5500",
            "fax_number": "415-321-1088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GRAHAM",
        "middle_name": "KYLE",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-07",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A12961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Johnson
• Gary L Johnson, MA, CMT
• Gary Wayne Johnson, MFT
• Geraldine Vernette Johnson
• Glenda Lanae Johnson
• Hannah Johnson
• Heather Marie Johnson
• Infiniti Johnson
• Jacob Johnson, MD
• James Johnson

• Psychiatry Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; 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.

Verify at the official NPI Registry.