Individual provider Active NPI

Marilyn Johnson, D.C.

  • Chiropractor
  • Altadena, CA
National Provider Identifier
1992031033
Registry record updated Oct 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 26880 Issued in CA
Practice address
1911 Lake Ave
Altadena, CA 91001-3037
Phone
(323) 828-8111
NPI assigned
Oct 25, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 26880 CA Primary

Addresses

Primary practice location

1911 Lake Ave
Altadena, CA 91001-3037

Mailing address

1911 Lake Ave
Altadena, CA 91001-3037
Phone (323) 828-8111

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

State licenses

LicenseStateTypeSpecialty
DC 26880CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1256428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256428800000",
    "number": "1992031033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 LAKE AVE",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910013037",
            "telephone_number": "323-828-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 LAKE AVE",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910013037",
            "telephone_number": "323-828-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARILYN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-25",
        "last_updated": "2009-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 26880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2009; 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.