Nick J Johnson I, N.M.D.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

17-1629 Issued in AZ

Practice address

9700 N 91St St Ste A115
Scottsdale, AZ 85258-5036

Phone

(480) 322-8577

NPI assigned

Jul 1, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1498867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1851812671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3757 E SEXTON ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852957210",
            "telephone_number": "480-322-8577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 N 91ST ST STE A115",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585036",
            "telephone_number": "480-322-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "N.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-01",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "AZ",
            "license": "17-1629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495858",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "9700 N 91st St Ste A115",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852585036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Inez Johnson, MSC, LAC
• Louise Johnson, COTA/L
• M. Natasha Johnson, RDN
• Marrissa Johnson
• Michael Eugene Johnson
• Olivia Alexandra Johnson, DO
• Patricia I. Johnson, PH.D.
• Phoebe Noelle Johnson, DO
• Randall J. Johnson, D.D.S.
• Rona Johnson

• Adult Medicine Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Adult Medicine Physician in Arizona

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