Active NPI
Michael Cottrell Johnson
- Attendant Care Provider
- Mercer Island, WA
National Provider Identifier
1902440266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Attendant Care Provider
- License
- 10052933
- Practice address
- 3812 W. Mercer Way
Mercer Island, WA 98040 - Phone
- (206) 232-8158
- NPI assigned
- Oct 30, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | 10052933 | WA | Primary |
Addresses
Primary practice location
3812 W. Mercer Way
Mercer Island, WA 98040
Mailing address
P.O. Box 994
Mercer Island, WA 98040
Phone (206) 375-9583
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10052933 | WA | MD | Attendant Care Provider |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572393600000",
"number": "1902440266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 994",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "98040",
"telephone_number": "206-375-9583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3812 W. MERCER WAY",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "98040",
"telephone_number": "206-232-8158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MICHAEL",
"middle_name": "COTTRELL",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-10-30",
"last_updated": "2019-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": "WA",
"license": "10052933",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mercer Island, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.