Van W. Johnson MD PC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MD013857E Issued in PA

Legal business name

VAN W. JOHNSON MD PC

Practice address

103 W Saint Clair St
Warren, PA 16365-2197

Phone

(814) 726-1921

Fax

(814) 726-7881

NPI assigned

Mar 29, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Susan Nordin

Title

Manager

Phone

(814) 726-1921

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dan Henry Gottwald, MD

  • Orthopaedic Surgery Physician
  • Warren, PA
  • NPI 1104889732
  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700906583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W SAINT CLAIR ST",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652197",
            "telephone_number": "814-726-1921",
            "fax_number": "814-726-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W SAINT CLAIR ST",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652197",
            "telephone_number": "814-726-1921",
            "fax_number": "814-726-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN W. JOHNSON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NORDIN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "814-726-1921"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD013857E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD INDIVIDUAL",
            "identifier": "105684",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP",
            "identifier": "1938251",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Total Renal Care Inc (Warren Dialysis)
• Mackenzie Tray, DO
• Joanne L Tridico, CRNA
• Edana Tudor
• Charlotte M Uber, LSW
• Philip Lamont Vance, DC
• Vantage DME Partnership (Vantage Home Medical Equipment & Services)
• Jared C Varner, PA-C
• Carrie Lynn Vaughn
• Alexis Rose Vavala

• Orthopaedic Surgery Physician in Warren, PA
• Providers in Warren, PA by specialty
• Orthopaedic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.