Individual provider Active NPI

Taylor Marilyn Johnston, MD

  • Emergency Medicine Physician
  • Redmond, OR
National Provider Identifier
1831536762
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
175861 Issued in OR
Practice address
1253 NW Canal Blvd
Redmond, OR 97756-1334
Phone
(541) 548-8131
Fax
(541) 460-4028
NPI assigned
Jun 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 175861 OR Primary

Addresses

Primary practice location

1253 NW Canal Blvd
Redmond, OR 97756-1334

Mailing address

PO Box 6096
Bend, OR 97708-6096
Phone (541) 548-8131

Other identifiers 1

IdentifierTypeStateIssuer
50710OtherAZARIZONA MEDICAL BOARD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tjohnston18192@secure.stcharleshealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160506001746 OR Practitioner - Emergency Medicine 4587963889 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
175861ORMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. CurrentSince Oct 15, 2016 Accepting new patients
St. Charles Health System, Inc. CurrentSince Oct 15, 2016 Accepting new patients
St. Charles Health System, Inc. CurrentSince Jun 30, 2016 Accepting new patients
St. Charles Health System, Inc. Emergency Medicine Current Accepting new patients
St. Charles Health System, Inc. CurrentSince Jun 30, 2016 Accepting new patients
St. Charles Health System, Inc. Emergency Medicine CurrentSince Jan 1, 2026 Accepting new patients
St. Charles Health System, Inc. Emergency Medicine CurrentSince Jan 1, 2026 Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

61250 SE Coombs Pl
Bend, OR 97702
Phone (541) 706-5930

470 NE A St
Madras, OR 97741
Phone (541) 383-3668

384 SE Combs Flat Rd
Prineville, OR 97754
Phone (541) 383-3668

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

Interoperability endpoints

  • Direct secure messaging: tjohnston18192@secure.stcharleshealthcare.org

Organizations & group practices 7

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": "1370131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1831536762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6096",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977086096",
            "telephone_number": "541-548-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1253 NW CANAL BLVD",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561334",
            "telephone_number": "541-548-8131",
            "fax_number": "541-460-4028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "TAYLOR",
        "middle_name": "MARILYN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-02",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "175861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA MEDICAL BOARD",
            "identifier": "50710",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tjohnston18192@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "1253 NW Canal Blvd",
            "city": "Redmond",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977561334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

Verify at the official NPI Registry.