Paul W Johnson, D.O.

Primary specialty

Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X

License

DO28084 Issued in OR

Practice address

2222 NW Lovejoy St
Ste 522
Portland, OR 97210-3033

Phone

(503) 810-6555

Fax

(503) 286-7939

NPI assigned

Aug 31, 2006

Last updated

Dec 28, 2016By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

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 2

Specialty

Sports MedicineAlso: Osteopathic Manipulative Medicine

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Pursuit Sports Medicine LLC

  dba Paul W Johnson, DO

  • Sports Medicine (Internal Medicine) Physician
  • Portland, OR
  • NPI 1447705801

  WA

  Medicare reassignment NPD Authorized official
• Richa Uppal MD LLC

  dba Richa Uppal MD

  • Primary Care Clinic/Center
  • Portland, OR
  • NPI 1548084312
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Legacy Good Samaritan Hospital and Medical Center

  dba Legacy Good Samaritan Providers

  • Clinic/Center
  • Portland, OR
  • NPI 1679597108

  Hospital

  Care Compare affiliation
• Legacy Good Samaritan Hospital and Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1780608216
  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482883200000",
    "number": "1689785925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3439 NE SANDY BLVD",
            "address_2": "# 234",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321959",
            "telephone_number": "503-978-0178",
            "fax_number": "503-286-7939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST",
            "address_2": "STE 522",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103033",
            "telephone_number": "503-810-6555",
            "fax_number": "503-286-7939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAUL",
        "middle_name": "W",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "OR",
            "license": "DO28084",
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "OR",
            "license": "DO28084",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8467474",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Kathleen Johnson, DNP, APRN, CRNA
• Nina Johnson
• Pamela Anne Johnson, L.AC.
• Patricia Guadalupe Johnson
• Patrick F Johnson, PH.D.
• Penelope J Johnson
• Penny Lee Johnson, R.D.H.
• Peyton Selena Johnson, MD
• Phillip Johnson
• Quin Johnson

• Sports Medicine (Internal Medicine) Physician in Portland, OR
• Providers in Portland, OR by specialty
• Sports Medicine (Internal Medicine) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.