NPIMap

Individual provider Active NPI

Cory T Johnson, M.D.

  • Specialist
  • Klamath Falls, OR
National Provider Identifier
1851407282
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD24075 Issued in OR
Practice address
2301 Mountain View Blvd
Suite a
Klamath Falls, OR 97601-1137
Phone
(541) 884-6374
Fax
(541) 884-6731
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD24075 OR Primary

Addresses

Primary practice location

2301 Mountain View Blvd
Suite a
Klamath Falls, OR 97601-1137

Mailing address

2301 Mountain View Blvd
Suite a
Klamath Falls, OR 97601-1137
Phone (541) 884-6374

Other identifiers 1

IdentifierTypeStateIssuer
286362MedicaidOR

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD24075ORMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Katherine L. Hilsinger MD PC Past Accepting new patients
Sky Lakes Medical Center Inc Past Accepting new patients
West Physician Services LLC Past Accepting new patients

Organizations & group practices 3

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1851407282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 MOUNTAIN VIEW BLVD",
            "address_2": "SUITE A",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011137",
            "telephone_number": "541-884-6374",
            "fax_number": "541-884-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 MOUNTAIN VIEW BLVD",
            "address_2": "SUITE A",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011137",
            "telephone_number": "541-884-6374",
            "fax_number": "541-884-6731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CORY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD24075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286362",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.