DR. SAMUEL STUART JOHNSON (NPI# 1043212749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043212749 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL STUART JOHNSON |
| Credential | M.D. |
| Practice Address |
1058 College Dr New Town ND 58763-9112 |
| Mailing Address |
315 Main St # 676 New Town ND 58763-4000 |
| Practice Telephone | 7016274750 |
| Practice Fax Number | 8888778471 |
| Mailing Telephone | 3854141376 |
| Mailing Fax Number | 8888778471 |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2015-05-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 12967 | NV | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 6454773-1205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 003763400 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780176677 | Samuel Eric Johnson | Dentist | 5128 Old Highway 11 Ste 7, Hattiesburg, MS 39402-6234 | 2018-06-05 |
| 1245730787 | Samuel Johnson | Behavior Technician | 17688 71st Ln N, Loxahatchee, FL 33470-5501 | 2018-02-20 |
| 1902357874 | Samuel Alexander Johnson | Counselor | 16755 Hughes Rd, Victorville, CA 92395-4563 | 2016-10-17 |
| 1184095556 | Samuel Lee Johnson IIi | Counselor | 2100 Woodmere Blvd Ste 135, Harvey, LA 70058-2294 | 2015-10-12 |
| 1558740803 | Samuel Johnson | Physician Assistant | 2901 Metro Drive, Suite 527, Bloomington, MN 55122 | 2015-05-20 |
| 1487032751 | Samuel H Johnson | Social Worker | 500 Adams Street, Box 3243, Seward, AK 99664-3243 | 2015-05-07 |
| 1285034496 | Samuel Johnson II | Specialist/Technologist | 220 Champions Drive, Harrisonburg, VA 22807-2478 | 2014-08-26 |
| 1528475092 | Samuel Johnson | Specialist/Technologist | 101 Womens Bldg, Oregon State University, Corvallis, OR 97331-8577 | 2014-07-16 |
| 1306111729 | Samuel Johnson | Counselor | 201 Humiston Cir, Thomaston, CT 06787-1223 | 2012-03-19 |
| 1205074846 | Samuel Charles-prabhakar Johnson | Physical Therapist | 1026 46th St, Brooklyn, NY 11219-2401 | 2009-02-03 |
| Street Address |
1058 COLLEGE DR |
| City | NEW TOWN |
| State | ND |
| Zip Code | 58763-9112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641105 | Xaviera Pascale Nyandjo | Pharmacist | 1058 College Dr, New Town, ND 58763-9112 | 2020-05-25 |
| 1720600927 | Gwendolyn Ashley Davis | Registered Nurse | 1058 College Dr, New Town, ND 58763-9112 | 2020-05-11 |
| 1407493216 | Lenaya Marie Martin | Nurse Practitioner | 1058 College Dr, New Town, ND 58763-9112 | 2019-11-30 |
| 1558918045 | Sadie Jayne Dale | Physical Therapist | 1058 College Dr, New Town, ND 58763-9112 | 2019-08-20 |
| 1326501826 | Gregory L Fondong | Pharmacist | 1058 College Dr, New Town, ND 58763-9112 | 2019-04-11 |
| 1659845907 | Jennifer Jordan | Radiology | 1058 College Dr, New Town, ND 58763-9112 | 2019-01-18 |
| 1689146201 | Jared Eagle | Health Educator | 1058 College Dr, New Town, ND 58763-9112 | 2018-12-20 |
| 1164991881 | Shelby Stein | Dietitian, Registered | 1058 College Dr, New Town, ND 58763-9112 | 2018-11-26 |
| 1124511415 | Douglas Mai | Radiology | 1058 College Dr, New Town, ND 58763-9112 | 2018-06-11 |
| 1497242689 | Bridget Peters | Dentist | 1058 College Dr, New Town, ND 58763-9112 | 2018-04-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104332337 | Opportunity Foundation Inc | Day Training, Developmentally Disabled Services | 709 E Eagel Dr, New Town, ND 58763 | 2017-12-26 |
| 1225437460 | New Town Health Support Corporation | Assisted Living Facility | 603 1st Street Nw, New Town, ND 58763 | 2014-08-13 |
| 1992099477 | Debbie Joyce Jeanotte | Registered Nurse | 1 Minne-tohe Drive, Minne-tohe Health Center, New Town, ND 58763 | 2011-06-02 |
| 1831365519 | Elbowoods Memorial Health Center | Clinic/Center | 1058 College Drive, New Town, ND 58763 | 2008-05-02 |
| 1467622704 | Tri City Cares, Inc. | PACE Provider Organization | 709 E Eagle Dr, New Town, ND 58763 | 2008-03-03 |
| 1417028978 | Nora M Rasmussen | Nurse Practitioner | 604 1st St N, New Town, ND 58763 | 2006-11-13 |
| 1194249417 | Cianna Marie Rabbithead | Counselor | 1058 College Drive, New Town, ND 58763 | 2017-07-28 |
| 1619423308 | Ty Thompson | Counselor | 304 7th St N, New Town, ND 58763 | 2016-09-01 |
| 1508051483 | Traci Weaver | Pharmacy Technician | 334 Main Street, New Town, ND 58763 | 2007-09-13 |
| 1467527820 | Cheryl D Ulven | Physician Assistant | 604 1st St N, New Town, ND 58763 | 2006-11-21 |
| Find all providers in zip 58763 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730234451 | Philip Elijah Mcrill | Family Medicine | 1 Minni Tohe Dr, New Town, ND 58763-4400 | 2007-01-24 |
| 1639192008 | Zane C Rising Sun | Family Medicine | 1058 College Dr, New Town, ND 58763-9112 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679068035 | Rory Ratzlaff | Family Medicine | Sanford Health 737 Broadway N, Fargo, ND 58122-0001 | 2018-06-28 |
| 1710472725 | Shabnum Gupta | Family Medicine | Sanford Health 801 Broadway North, Fargo, ND 58122-0170 | 2018-06-22 |
| 1538661384 | Community Uplift Program | Family Medicine | 417 Main Ave Ste 401, Fargo, ND 58103-1956 | 2018-03-07 |
| 1134578537 | Nicole Samson | Family Medicine | 1001 7th Street Ne - Altru Clinic/devils Lake, Devils Lake, ND 58301-2719 | 2016-06-07 |
| 1508241183 | Edith Wong | Family Medicine | 701 E Rosser Ave., Bismarck, ND 58501-4461 | 2015-07-24 |
| 1417343831 | Ashley Lynn Loughner | Family Medicine | 194 Missle Ave, 5 Mdg, Minot Afb, ND 58705-5024 | 2015-04-13 |
| 1821404260 | Rachel Wanzek | Family Medicine | 300 2nd Ave Ne Ste 212, Jamestown, ND 58401-3377 | 2014-07-07 |
| 1215341417 | Benjamin H Roth | Family Medicine | 860 South Columbia Road, Grand Forks, ND 58201 | 2014-06-16 |
| 1982031746 | Turtle Mountain Family Medicine, LLC | Family Medicine | 115 Main Street Ne, Dunseith, ND 58329 | 2013-10-10 |
| 1861828212 | Viscito Family Medicine, Pllc | Family Medicine | 2750 S 26th St, Suite C, Grand Forks, ND 58201-6432 | 2013-09-17 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. SAMUEL STUART JOHNSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.