Kaitlund Rakel Johnson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD61242890 Issued in WA

Practice address

624 E Front Ave
Spokane, WA 99202-2139

Phone

(509) 626-9900

Fax

(509) 626-9917

NPI assigned

Apr 29, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kaitlund Rakel Tangvald Former name

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Internal Medicine

Education

University of Washington School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services WashingtonGroup PAC ID 0345139929, 778 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ktangvald797669@wm.providencedirect.org

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.

• Providence Health & Services Washington

  dba Providence Medical Group

  • Pulmonary Disease Physician
  • Spokane, WA
  • NPI 1194099390

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Providence Health & Services Washington

  dba PMG PHC Providence Express Care

  • General Practice Physician
  • Spokane, WA
  • NPI 1306391446
  NPD
• Providence Health & Services - Wa

  dba Prov Scred Hrt Med Ctr & Chlds Hos

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1144471715
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services - Wa

  dba Prov Scred Hrt Med Ctr & Chlds Hos

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1144471715
  Care Compare affiliation

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1922662592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 E FRONT AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022139",
            "telephone_number": "509-626-9900",
            "fax_number": "509-626-9917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 E FRONT AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022139",
            "telephone_number": "509-626-9900",
            "fax_number": "509-626-9917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KAITLUND",
        "middle_name": "RAKEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "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": "WA",
            "license": "MD61242890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLUND",
            "last_name": "TANGVALD",
            "middle_name": "RAKEL",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Ann Johnson, LMP
• Jessie Rae Johnson, CCC-SLP
• Jihye Johnson, DNP, ARNP, NP-C
• Joshua L Johnson, D.D.S., M.S.
• Julie M Johnson, COTA
• Kalila Johnson, LMFTA
• Katarina Chantel Johnson, BA
• Katharine Maye Johnson
• Kathleen Johnson
• Kathryn Lorraine Johnson, MS, ATC, CSCS

• Internal Medicine Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.