Individual provider Active NPI

Karrie Johnson, PA-C

  • Surgical Physician Assistant
  • Eugene, OR
National Provider Identifier
1740448950
Registry record updated May 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
55 Coburg Rd
Eugene, OR 97401
Phone
(541) 485-8111
NPI assigned
May 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

55 Coburg Rd
Eugene, OR 97401

Mailing address

55 Coburg Rd
Eugene, OR 97401-2433
Phone (541) 485-8111

Other practice location 1

4311 11th Ave NE
suite 200
Seattle, WA 98105-6366
Phone (206) 616-4001

Other practice location 2

3377 Riverbend Dr
Springfield, OR 97477-8803
Phone (541) 485-8111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240812000483 SD Practitioner - Physician Assistant 2769738194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera St LukesGroup PAC ID 6406764927, 164 clinicians

Practice addresses (Care Compare)

1401 10TH Ave W
Mobridge, SD 57601-1106
Phone (605) 622-2573

305 S State St
Aberdeen, SD 57401-4527
Phone (605) 622-5100

701 8TH Ave NW
Aberdeen, SD 57401-1865

8 E US Hwy 12
Groton, SD 57445-2176
Phone (605) 397-4242

Hospital & facility affiliations

  • Avera St Lukes Hospital, Aberdeen, SD, CCN 430014
  • Mobridge Regional Hospital - Cah Hospital, Mobridge, SD, CCN 431325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St. Lukes CurrentSince Jun 9, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: karrie.johnson@avera.sdhealthlink.net

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1211760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526860800000",
    "number": "1740448950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 COBURG RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012433",
            "telephone_number": "541-485-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 COBURG RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97401",
            "telephone_number": "541-485-8111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4311 11th Ave NE",
            "address_2": "suite 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981056366",
            "country_code": "US",
            "telephone_number": "206-616-4001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3377 Riverbend Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974778803",
            "country_code": "US",
            "telephone_number": "541-485-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KARRIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-26",
        "last_updated": "2018-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.