DR. BYRON JOHNSON (NPI# 1215368071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215368071 |
| Entity Type | Individual |
| Full Name | DR. BYRON JOHNSON |
| Credential | MD |
| Practice Address |
1944 Shryer Ave W Roseville MN 55113-5415 |
| Mailing Address |
856 Manomin Ave Saint Paul MN 55107-3512 |
| Practice Telephone | 6516339080 |
| Mailing Telephone | 6512274848 |
| Enumeration Date | 2013-12-04 |
| Last Update Date | 2013-12-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 18769 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 900282100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902296080 | Byron Melvin Johnson | Nurse Practitioner | 1833 Boulevard, Jacksonville, FL 32206-4382 | 2015-01-28 |
| 1336236959 | Byron W Johnson | Radiology | 1100 E Norris Dr, Ottawa, IL 61350-1604 | 2006-10-06 |
| Street Address |
1944 SHRYER AVE W |
| City | ROSEVILLE |
| State | MN |
| Zip Code | 55113-5415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
| 1467010330 | Ahmed Issa | Student in an Organized Health Care Education/Training Program | 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 | 2019-06-05 |
| 1821653833 | Suite Living Senior Care of Little Canada | Assisted Living Facility | 2740 Rice Street, Little Canada, MN 55113 | 2019-05-06 |
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1588138473 | Applewood Home Health Care, LLC | Home Health | 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 | 2019-01-14 |
| 1699251520 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2685 Patton Rd, Roseville, MN 55113 | 2018-07-13 |
| 1083104145 | Suite Living Senior Care of Roseville | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55113 | 2018-05-15 |
| 1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
| 1194223024 | Alissa Hoff | Specialist | 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 | 2018-01-25 |
| 1841705118 | Kingsland Care Services Incorporated | Case Management | 2301 Rice Street, Suite 101, Roseville, MN 55113 | 2017-12-08 |
| Find all providers in zip 55113 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528227253 | Judy A Cook | Pediatrics | 1856 Ridgeview Dr, Roseville, CA 95661-5835 | 2008-06-06 |
| 1235352220 | Rhonette Estelle Jackson | Pediatrics | 151 N Sunrise Ave Ste 1309, Roseville, CA 95661-2933 | 2007-04-10 |
| 1497892772 | Meghan Norton Davignon | Pediatrics | 1600 Eureka Rd Bldg C2nd, Roseville, CA 95661-3027 | 2007-01-30 |
| 1134291453 | David L Bannister | Pediatrics | 729 Sunrise Ave #501, Roseville, CA 95661 | 2006-11-14 |
| 1962473686 | Lakshmi Kumari Avala | Pediatrics | 902 Cirby Way, Roseville, CA 95661-4420 | 2006-01-30 |
| 1821090945 | Craig C Corp | Pediatrics | 3100 Douglas Blvd, Roseville, CA 95661-3866 | 2005-06-01 |
| 1023551751 | Olivia Hoang-kelada | Pediatrics | 2261 Douglas Blvd, Roseville, CA 95661-3831 | 2016-11-29 |
| 1083078091 | Patricia Tenold | Pediatrics | 1840 Sierra Gardens Dr, Roseville, CA 95661-2912 | 2016-04-06 |
| 1396139853 | Sarah Elizabeth Henshaw | Pediatrics | 3100 Douglas Blvd, Roseville, CA 95661 | 2015-03-23 |
| 1619223534 | Kathy Lewis | Pediatrics | 151 N Sunrise Ave Ste 1309, Roseville, CA 95661-2933 | 2012-07-29 |
| Find all providers in ROSEVILLE | ||||
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| 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.