Active NPI
Allie Elaine Johnston, DO
- Pediatrics Physician
- Fresno, CA
National Provider Identifier
1679079073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 20A17999
- Practice address
- 2823 Fresno St
Fresno, CA 93721-1324 - Phone
- (559) 499-6556
- Fax
- (559) 499-6561
- NPI assigned
- Apr 4, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 20A17999 | CA | Primary |
Addresses
Primary practice location
2823 Fresno St
Fresno, CA 93721-1324
Mailing address
2625 E Divisadero St
Fresno, CA 93721-1431
Phone (559) 443-2682
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A17999 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wilcox Memorial Hospital | Past | Accepting new patients | |
| Sang Medical Corp | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pediatrics Physician
- Fresno, CA
- NPI 1003251687
-
- Rural Acute Care Hospital
- Lihue, HI
- NPI 1225113442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617062400000",
"number": "1679079073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 E DIVISADERO ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937211431",
"telephone_number": "559-443-2682",
"fax_number": "559-443-2682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2823 FRESNO ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937211324",
"telephone_number": "559-499-6556",
"fax_number": "559-499-6561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "ALLIE",
"middle_name": "ELAINE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-04",
"last_updated": "2021-03-30",
"certification_date": "2021-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "20A17999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.