Individual provider Active NPI

Jeffrey Johnson, DVM

  • Veterinarian
  • Redding, CA
National Provider Identifier
1962776039
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
9588 Issued in CA
Practice address
1405 Bradford Way
Redding, CA 96003-4074
Phone
(530) 221-6733
NPI assigned
Mar 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X 9588 CA Primary

Addresses

Primary practice location

1405 Bradford Way
Redding, CA 96003-4074

Mailing address

1405 Bradford Way
Redding, CA 96003-4074

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

NPI Registry JSON

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1962776039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 BRADFORD WAY",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960034074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 BRADFORD WAY",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960034074",
            "telephone_number": "530-221-6733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DVM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-06",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "CA",
            "license": "9588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; 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.