Johnson Family Chiropractic & Sports Clinic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

JOHNSON FAMILY CHIROPRACTIC & SPORTS CLINIC PLLC

Practice address

2745 Pole Line Rd
Pocatello, ID 83201-6111

Phone

(208) 234-2225

NPI assigned

Oct 2, 2018

Organization subpart

No

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

Authorized official

Name

Gary L Johnson, DCNPI 1588721930

Title

Owner

Phone

(208) 234-2225

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gary L Johnson II, DC

  • Chiropractor
  • Pocatello, ID
  • NPI 1588721930
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538438400000",
    "number": "1679058093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2745 POLE LINE RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832016111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 POLE LINE RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832016111",
            "telephone_number": "208-234-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON FAMILY CHIROPRACTIC & SPORTS CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-02",
        "last_updated": "2018-10-02",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-234-2225",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikki K Johansen
• Gary R Johanson, CRNA
• John Fornarotto PLLC
• John L Christensen PHD PC
• Johnson & Snow Dental, PA
• Alyssa Lenae Johnson
• Brandon Johnson, PTA
• Eric D Johnson, DDS MS
• Gary L Johnson II, DC
• Joni Lynn Johnson, DPT

• Chiropractor in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.