Samuel Ervine Johnston II, HIS

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

440 Issued in CT

Practice address

9 Sutula Rd
Suffield, CT 06078-2265

Phone

(860) 916-6169

Fax

(860) 906-3391

NPI assigned

Jan 26, 2016

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 26, 2016.

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1922465574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 SUTULA RD",
            "city": "SUFFIELD",
            "state": "CT",
            "postal_code": "060782265",
            "telephone_number": "860-916-6169",
            "fax_number": "860-906-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 SUTULA RD",
            "city": "SUFFIELD",
            "state": "CT",
            "postal_code": "060782265",
            "telephone_number": "860-916-6169",
            "fax_number": "860-906-3391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "SAMUEL",
        "middle_name": "ERVINE",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "HIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CT",
            "license": "440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Suffield, CT
• Hearing Instrument Specialist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.