Sara L Johnson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M4188 Issued in ID

Practice address

496 Shoup Ave W
Suite E
Twin Falls, ID 83301

Phone

(208) 733-2885

Fax

(208) 754-3352

NPI assigned

Aug 2, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Gem State Family Health Care PLLC

  • Primary Care Clinic/Center
  • Twin Falls, ID
  • NPI 1427537927
  NPD (past)

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1881601698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 SHOUP AVE W",
            "address_2": "SUITE E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "83301",
            "telephone_number": "208-733-2885",
            "fax_number": "208-754-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SHOUP AVE W",
            "address_2": "SUITE E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "83301",
            "telephone_number": "208-733-2885",
            "fax_number": "208-754-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SARA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M4188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF ID",
            "identifier": "57570",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001484000",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF ID",
            "identifier": "000010001118",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Scott Johnson, C.P.O
• Paul Johnson, DMD
• Rhonda Michelle Johnson, LMSW
• Robert Max Johnson Jr., D.C.
• Samantha Wynn Johnson, NP
• Sarah Johnson, AUD
• Allison Johnston, DPT
• Jaclyn Johnson Jolley, PA
• Jolliff Counseling & Behavioral Health
• Jolliff Counseling & Behavioral Health

• Family Medicine Physician in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; 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.