Yvonne M Johnson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005071 Issued in MI

Practice address

15TH Medical Group
755 Scott Circle
Hickam Afb, HI 96853-5399

Phone

(808) 448-6211

Fax

(808) 448-6356

NPI assigned

Aug 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233792000000",
    "number": "1801087614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15TH MEDICAL GROUP",
            "address_2": "755 SCOTT CIRCLE",
            "city": "HICKAM AFB",
            "state": "HI",
            "postal_code": "968535399",
            "telephone_number": "808-448-6211",
            "fax_number": "808-448-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15TH MEDICAL GROUP",
            "address_2": "755 SCOTT CIRCLE",
            "city": "HICKAM AFB",
            "state": "HI",
            "postal_code": "968535399",
            "telephone_number": "808-448-6211",
            "fax_number": "808-448-6356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "YVONNE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2009-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD271",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Mark Hall, CADAC
• Robert Hetue, PHARMD
• Hickam Afb 15TH MDG
• Hickam Phcy
• Michael Johnson Hsu, PHARM D
• Micah T Keaney, PSYD
• John Hankil Kim, D.O.
• Melissa Sue Kruse, DDS
• Betsy Ann Lefebvre, DDS
• Jeffery Michael Lerma, PA-C

• Physician Assistant in Hickam Afb, HI
• Providers in Hickam Afb, HI by specialty
• Physician Assistant in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.