Wayne William Johnson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

243 Issued in CO

Practice address

799 E Hampden Ave
#400
Englewood, CO 80113-2700

Phone

(303) 789-2663

Fax

(303) 788-4871

NPI assigned

Mar 5, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1362441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1982945788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 S MONACO ST",
            "address_2": "#210",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802373486",
            "telephone_number": "303-789-2663",
            "fax_number": "303-788-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 E HAMPDEN AVE",
            "address_2": "#400",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132700",
            "telephone_number": "303-789-2663",
            "fax_number": "303-788-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "WAYNE",
        "middle_name": "WILLIAM",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-05",
        "last_updated": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201076740A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82603219",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "WAYNE.JOHNSON@hca3.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "799 E Hampden Ave",
            "address_2": "#400",
            "city": "Englewood",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801132700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michaela Johnson
• Nicole Johnson
• Stephanie Johnson, LMFT
• Taylor Johnson
• Tim R Johnson, PAC
• Marva Lynn Jolly, MNT
• Richard W Jolly, OD
• Craig C Jonas, MD
• Rebecca Jean Jonell, OTR/L
• Benjamin Jones, LMFT

• Physician Assistant in Englewood, CO
• Providers in Englewood, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.