Keith Johnson, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD187490 Issued in OR

Practice address

5 Centerpointe Dr
Lake Oswego, OR 97035-8651

Phone

(503) 606-6355

Fax

(503) 404-4555

NPI assigned

Apr 10, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Kajmd LLC

  dba Integrative Mind

  • Psychiatry Physician
  • Lake Oswego, OR
  • NPI 1114542735
  NPD Authorized official
• Legacy Emanuel Hospital & Health Center

  dba Apothecary at Emanuel Hospital

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1417977976
  NPD
• Legacy Emanuel Hospital & Health Center

  • Clinic/Center
  • Portland, OR
  • NPI 1700809027

  Psychiatry

  NPD
• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358
  NPD
• Grow Wild Therapy Center, LLC

  • Mental Health Counselor
  • Portland, OR
  • NPI 1326837808
  NPD (past)

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1982023479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CENTERPOINTE DR STE 400",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358661",
            "telephone_number": "503-606-6635",
            "fax_number": "581-333-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CENTERPOINTE DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358651",
            "telephone_number": "503-606-6355",
            "fax_number": "503-404-4555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 SE Spokane St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97202",
            "country_code": "US",
            "telephone_number": "503-606-6635",
            "fax_number": "581-333-1291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KEITH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-10",
        "last_updated": "2023-02-24",
        "certification_date": "2023-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "9601928-1205",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD187490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Johnson, PSY.D
• Deirdre Johnson, PHARM.D.
• Dona D Johnson
• Elizabeth Irwin Johnson
• Janice Johnson, LPC
• Kendall Amanda Johnson, PA-C
• Shylo Johnson, LMT
• Tiamoya Johnson
• Joie de Vivre Counseling LLC
• Anastasia Jones, PSYD

• Psychiatry Physician in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.