Individual provider Active NPI

Joseph Douglas Johnson, M.D.

  • Internal Medicine Physician
  • Lakewood, CO
National Provider Identifier
1891094074
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR.0053960 Issued in CO
Practice address
8405 W Alameda Ave
Lakewood, CO 80226-2908
Phone
(720) 974-5400
Fax
(720) 974-4992
NPI assigned
Mar 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X DR-53960 CO
Internal Medicine Physician 207R00000X DR.0053960 CO Primary

Addresses

Primary practice location

8405 W Alameda Ave
Lakewood, CO 80226-2908

Mailing address

8175 Sheridan Blvd
Unit N
Arvada, CO 80003-1956
Phone (303) 557-0855

Other practice location 1

8175 Sheridan Blvd
Unit N
Arvada, CO 80003-1956
Phone (303) 557-0855

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200826003349 CO Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4284937921

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR-53960COMDInternal Medicine Physician
DR.0053960COMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1301184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1891094074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8175 SHERIDAN BLVD",
            "address_2": "UNIT N",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800031956",
            "telephone_number": "303-557-0855",
            "fax_number": "720-336-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8405 W ALAMEDA AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802262908",
            "telephone_number": "720-974-5400",
            "fax_number": "720-974-4992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8175 Sheridan Blvd",
            "address_2": "Unit N",
            "address_purpose": "LOCATION",
            "city": "Arvada",
            "state": "CO",
            "postal_code": "800031956",
            "country_code": "US",
            "telephone_number": "303-557-0855",
            "fax_number": "720-336-3149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOSEPH",
        "middle_name": "DOUGLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR-53960",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0053960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.