Active NPI
Robert A Johnson, D.C.
- Chiropractor
- Fairfield, IA
National Provider Identifier
1699863563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- AO5196
- Practice address
- 102 S 4TH St
Fairfield, IA 52556-3330 - Phone
- (641) 472-7333
- Fax
- (267) 373-4247
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | AO5196 | IA | Primary |
Addresses
Primary practice location
102 S 4TH St
Fairfield, IA 52556-3330
Mailing address
2094 185TH St Ste 40
Fairfield, IA 52556-8758
Phone (641) 472-7333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0207555 | Medicaid | IA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AO5196 | IA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269820800000",
"number": "1699863563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2094 185TH ST STE 40",
"city": "FAIRFIELD",
"state": "IA",
"postal_code": "525568758",
"telephone_number": "641-472-7333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 S 4TH ST",
"city": "FAIRFIELD",
"state": "IA",
"postal_code": "525563330",
"telephone_number": "641-472-7333",
"fax_number": "267-373-4247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ROBERT",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2010-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IA",
"license": "AO5196",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0207555",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.