Active NPI
Drew August Johnson, PA-C
- Physician Assistant
- Hayden, ID
National Provider Identifier
1851705347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA-1167
- Practice address
- 8836 N Hess St
Suite C
Hayden, ID 83835-8718 - Phone
- (208) 762-7760
- Fax
- (208) 762-7740
- NPI assigned
- Jun 12, 2014
- Last updated
- Jun 12, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA-1167 | ID | Primary |
Addresses
Primary practice location
8836 N Hess St
Suite C
Hayden, ID 83835-8718
Mailing address
8836 N Hess St
Suite C
Hayden, ID 83835-8718
Phone (208) 762-7760
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pivotal Whole Health Group | Current | Accepting new patients | |
| House Neuro-Rehabilitation Medicine PC | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- NPI 1700974714
-
- Medical Specialty Clinic/Center
- Hayden, ID
- NPI 1912181090
-
- Family Medicine Physician
- Coeur d'Alene, ID
- NPI 1588247092
-
- Physical Medicine & Rehabilitation Physician
- Spokane, WA
- NPI 1487242020
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402531200000",
"number": "1851705347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8836 N HESS ST",
"address_2": "SUITE C",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838358718",
"telephone_number": "208-762-7760",
"fax_number": "208-762-7740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8836 N HESS ST",
"address_2": "SUITE C",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838358718",
"telephone_number": "208-762-7760",
"fax_number": "208-762-7740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "DREW",
"middle_name": "AUGUST",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-12",
"last_updated": "2014-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ID",
"license": "PA-1167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayden, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.