Sally A Johnson, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OP6001031 Issued in WA

Practice address

2727 Hollycroft Street
Suite 390
Gig Harbor, WA 98335-1305

Phone

(253) 777-2077

Fax

(253) 432-4137

NPI assigned

Oct 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 30, 2020 through Nov 30, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308182400000",
    "number": "1861680373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 HOLLYCROFT STREET",
            "address_2": "SUITE 390",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351305",
            "telephone_number": "253-777-2077",
            "fax_number": "253-432-4137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 HOLLYCROFT STREET",
            "address_2": "SUITE 390",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351305",
            "telephone_number": "253-777-2077",
            "fax_number": "253-432-4137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SALLY",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2011-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP6001031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack N Johnson, ND
• Joni L Johnson, AUD, CCC-A
• Kathryn Marie Johnson, LMP
• Melanie K. Johnson, LMP
• Roger Dale Johnson, D.D.S.
• Simonne Chantal Johnson, ATC
• Sarah Johnston, OTR/L
• Diane Marie Jones, LMP
• Ryan Loren Jones, DDS
• Jordan Priess DDS PLLC

• Family Medicine Physician in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.