Individual provider Active NPI

Norman Edward Johnson, PA-C

  • Physician Assistant
  • Tucson, AZ
National Provider Identifier
1770554537
Registry record updated Sep 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1530 Issued in AZ
Practice address
2650 N Wyatt Dr
Tucson, AZ 85712-6106
Phone
(520) 320-4402
Fax
(520) 320-4406
NPI assigned
Jan 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1530 AZ Primary

Addresses

Primary practice location

2650 N Wyatt Dr
Tucson, AZ 85712-6106

Mailing address

2102 N Country Club Rd
BLDG B
Tucson, AZ 85716-2831
Phone (520) 795-8371

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1530AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiatry Associates, LTD CurrentSince Apr 23, 2002 Accepting new patients
Swea, P.C. Past Accepting new patients

Locations

2102 N Country Club Rd
Ste B
Tucson, AZ 85716
Phone (520) 323-7773

2650 N Wyatt Dr
Tucson, AZ 85712
Phone (520) 320-6230

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.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284076800000",
    "number": "1770554537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 N COUNTRY CLUB RD",
            "address_2": "BLDG B",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857162831",
            "telephone_number": "520-795-8371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 N WYATT DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857126106",
            "telephone_number": "520-320-4402",
            "fax_number": "520-320-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NORMAN",
        "middle_name": "EDWARD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2010-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.

Verify at the official NPI Registry.