Individual provider Active NPI

Joshua Cole Johnson, DC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1760265722
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.014028 Issued in IL
Practice address
3130 N Lake Shore Dr Apt 1405
Chicago, IL 60657-4920
Phone
(814) 592-8352
NPI assigned
Aug 15, 2023
Last updated
Jun 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.014028 IL Primary

Addresses

Primary practice location

3130 N Lake Shore Dr Apt 1405
Chicago, IL 60657-4920

Mailing address

3130 N Lake Shore Dr Apt 1405
Chicago, IL 60657-4920
Phone (814) 592-8352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241112003132 IL Practitioner - Chiropractic 8325572415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Active Wellness LLCGroup PAC ID 3072752864, 21 clinicians

Practice addresses (Care Compare)

4555 N Lincoln Ave
Chicago, IL 60625-2102
Phone (847) 791-7012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.014028ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Active Wellness LLC Chiropractor CurrentSince Aug 15, 2024 Accepting new patients
Active Wellness, LLC Chiropractor CurrentSince Aug 15, 2024 Accepting new patients

Locations

4555 N Lincoln Ave
Chicago, IL 60625
Phone (773) 328-8153

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1760265722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 N LAKE SHORE DR APT 1405",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574920",
            "telephone_number": "814-592-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 N LAKE SHORE DR APT 1405",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574920",
            "telephone_number": "814-592-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOSHUA",
        "middle_name": "COLE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-15",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.014028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.