Organization Active NPI

Donald Russell Johnson MD PHD

  • Dermatology Physician
  • Sitka, AK
National Provider Identifier
1871892786
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DONALD RUSSELL JOHNSON MD PHD
Practice address
209 Moller Ave
Sitka, AK 99835-7142
Phone
(907) 747-3241
NPI assigned
Mar 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

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

Authorized official

Name
Donald Russell Johnson, MD
Title
Owner
Phone
(360) 588-1480

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

209 Moller Ave
Sitka, AK 99835-7142

Mailing address

PO Box 50150
Bellevue, WA 98015-0150
Phone (425) 228-5228

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307491200000",
    "number": "1871892786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50150",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980150150",
            "telephone_number": "425-228-5228",
            "fax_number": "425-228-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 MOLLER AVE",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998357142",
            "telephone_number": "907-747-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD RUSSELL JOHNSON MD PHD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-17",
        "last_updated": "2011-06-08",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-588-1480",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sitka, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.