Individual provider Active NPI

Timothy J Johnson, MD

  • Physical Medicine & Rehabilitation Physician
  • La Crosse, WI
National Provider Identifier
1801871298
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
55178 Issued in WI
Practice address
800 West Ave S
La Crosse, WI 54601
Phone
(608) 785-0940
NPI assigned
Dec 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 30126 MN
Physical Medicine & Rehabilitation Physician 208100000X 55178 WI Primary

Addresses

Primary practice location

800 West Ave S
La Crosse, WI 54601

Mailing address

PO Box 1510
Eau Claire, WI 54702-1510
Phone (608) 785-0940

Other practice location 1

700 West Avenue S
La Crosse, WI 54601-4783
Phone (608) 392-9710

Other practice location 2

700 West Avenue S
La Crosse, WI 54601-4783
Phone (608) 392-9710

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30126MNMDEmergency Medicine Physician
55178WIMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1801871298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547021510",
            "telephone_number": "608-785-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WEST AVE S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "54601",
            "telephone_number": "608-785-0940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 West Avenue S",
            "address_purpose": "LOCATION",
            "city": "La Crosse",
            "state": "WI",
            "postal_code": "546014783",
            "country_code": "US",
            "telephone_number": "608-392-9710",
            "fax_number": "608-392-9429",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 West Avenue S",
            "address_purpose": "LOCATION",
            "city": "La Crosse",
            "state": "WI",
            "postal_code": "546014783",
            "country_code": "US",
            "telephone_number": "608-392-9710",
            "fax_number": "608-392-9429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "30126",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WI",
            "license": "55178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; 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.