Active NPI
Robert Tovey Johnson, DC
- Chiropractor
- Brookings, OR
National Provider Identifier
1891792131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3498
- Practice address
- 603 Hemlock St Ste 3B
Brookings, OR 97415-9425 - Phone
- (541) 708-2060
- Fax
- (541) 982-7019
- NPI assigned
- Jul 1, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC-26289 | CA | |
| Chiropractor | 111N00000X | 3498 | OR | Primary |
Addresses
Primary practice location
603 Hemlock St Ste 3B
Brookings, OR 97415-9425
Mailing address
1043 Chetco Ave # 141
Brookings, OR 97415-7152
Phone (541) 708-2060
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4586534 | Medicaid | CA | |
| 611981700 | Other | DEPT OF LABOR FECA # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, OR
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101012001203 | CA | Practitioner - Chiropractic | 8628260437 | Practice locations: Crescent City, CA |
| I20101118000730 | OR | Practitioner - Chiropractic | 8628260437 | Practice locations: Brookings, OR |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Western States College of Chiropractic, 1999
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
603 Hemlock St
Suite 3B
Brookings, OR 97415-9425
Phone (541) 708-2060
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3498 | OR | MD | Psychologist |
| DC-26289 | CA | MD | Chiropractor |
| 26289 | CA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Visana Wellness, LLC | Current | Accepting new patients | |
| Advance Farr Physical Therapy, Inc. | Past | Accepting new patients | |
| Interpath Laboratory, Inc. | Past | Accepting new patients |
Locations
603 Hemlock St
Ste 3B
Brookings, OR 97415
Phone (541) 469-9100
Organizations & group practices 3
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.
-
- Primary Care Clinic/Center
- Brookings, OR
- NPI 1427293349
-
- Clinical Medical Laboratory
- Pendleton, OR
- NPI 1548208440
-
- Physical Therapist
- Crescent City, CA
- NPI 1841411386
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715126400000",
"number": "1891792131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1043 CHETCO AVE # 141",
"city": "BROOKINGS",
"state": "OR",
"postal_code": "974157152",
"telephone_number": "541-708-2060",
"fax_number": "541-982-7019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "603 HEMLOCK ST STE 3B",
"city": "BROOKINGS",
"state": "OR",
"postal_code": "974159425",
"telephone_number": "541-708-2060",
"fax_number": "541-982-7019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ROBERT",
"middle_name": "TOVEY",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-01",
"last_updated": "2024-05-08",
"certification_date": "2024-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC-26289",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "3498",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4586534",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR FECA #",
"identifier": "611981700",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brookings, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.