DR. CARL R JOHNSON (NPI# 1275525701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275525701 |
| Entity Type | Individual |
| Full Name | DR. CARL R JOHNSON |
| Credential | M.D. |
| Practice Address |
500 Health Center Dr Suite 104 Mattoon IL 61938-9258 |
| Mailing Address |
Po Box 372 Mattoon IL 61938-0372 |
| Practice Telephone | 2172584080 |
| Practice Fax Number | 2172584084 |
| Mailing Telephone | 2172584080 |
| Mailing Fax Number | 2172584084 |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2015-01-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 036057126 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | PERSONALCARE HMO | 170490 | 01 |
| IL | BLUE CROSS BLUE SHIELD | 0001520105 | 01 |
| IL | 036057126 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720362288 | Carl Johnson | Contractor | 101 S 12th St, Mcalester, OK 74501-5656 | 2011-10-03 |
| 1356572440 | Carl Edward Johnson | Social Worker | 1537 W Adams St, #2r, Chicago, IL 60607-2451 | 2009-08-06 |
| 1083878490 | Carl R Johnson | Pharmacist | 524 Dean Hall Ct, Mt Pleasant, SC 29464-6204 | 2008-07-15 |
| 1205044369 | Carl Joseph Johnson | Dentist | 7241 Owensmouth Ave, Canoga Park, CA 91303-1530 | 2007-05-20 |
| 1700908670 | Carl Allen Johnson | Dermatology | 2610 Blossom St, Columbia, SC 29205-2308 | 2007-04-04 |
| 1427183847 | Carl Frederick Johnson | Marriage & Family Therapist | 2200 Century Parkway, Suite 200, Atlanta, GA 30345-3103 | 2007-02-23 |
| 1912063652 | Carl Austin Johnson | Physical Therapist | 285 W Francis, Blackfoot Physical Therapy, Blackfoot, ID 83221 | 2006-12-28 |
| 1437264033 | Carl L Johnson | Internal Medicine | 5320 W 12th St, Little Rock, AR 72204 | 2006-08-21 |
| 1144237215 | Carl E Johnson | Internal Medicine | 87 Herrick St, Beverly, MA 01915-2773 | 2006-08-02 |
| 1487679684 | Carl E Johnson | Pathology | 24 Las Praderas Dr, San Luis Obispo, CA 93401-7410 | 2006-07-12 |
| Street Address |
500 HEALTH CENTER DR SUITE 104 |
| City | MATTOON |
| State | IL |
| Zip Code | 61938-9258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740400597 | Sarah Bush Lincoln Health Center | Clinic/Center | 500 Health Center Dr, Suite 406, Mattoon, IL 61938-9258 | 2007-04-26 |
| 1861510901 | Sarah Bush Lincoln Health Center | Internal Medicine | 500 Health Center Dr, Suite 302, Mattoon, IL 61938-9258 | 2007-03-27 |
| 1770601817 | Sarah Bush Lincoln Health Center | Internal Medicine | 500 Health Center Dr, Suite 401, Mattoon, IL 61938-9258 | 2007-03-27 |
| 1689792723 | Sarah Bush Lincoln Health Center | Neurological Surgery | 500 Health Center Dr, Mattoon, IL 61938-9258 | 2007-03-27 |
| 1497873533 | Sarah Bush Lincoln Health Center | Orthopaedic Surgery | 500 Health Center Dr, Suite 101, Mattoon, IL 61938-9258 | 2007-03-27 |
| 1124146261 | Sarah Bush Lincoln Health Center | Pain Medicine | 500 Health Center Dr, Mattoon, IL 61938-9258 | 2007-03-27 |
| 1396863437 | Sarah Bush Lincoln Health Center | Pediatrics | 500 Health Center Dr, Suite 208, Mattoon, IL 61938-9258 | 2007-03-27 |
| 1477671519 | Sarah Bush Lincoln Health Center | Surgery | 500 Health Center Dr, Suite 301, Mattoon, IL 61938-9258 | 2007-03-27 |
| 1508984642 | Sarah Bush Lincoln Health Center | Otolaryngology | 500 Health Center Dr, Mattoon, IL 61938-9258 | 2007-03-27 |
| 1558489690 | Sarah Bush Lincoln Health Center | Obstetrics & Gynecology | 500 Health Center Dr, Suite 201, Mattoon, IL 61938-9258 | 2007-03-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043831134 | St Anthony's Memorial Hospital of The Hospital Sisters of The Third Or | Clinic/Center | 101 Coles Centre Pkwy, Ste 101, Mattoon, IL 61938 | 2020-04-30 |
| 1215436449 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 300 Coles Centre Pkwy, Mattoon, IL 61938 | 2018-02-02 |
| 1841707726 | Mattoon Chiropractic LLC | Chiropractor | 905 Remington Rd, Mattoon, IL 61938 | 2018-01-02 |
| 1164892758 | Dr. Charles L. Schnibben Ltd. | Dentist | 1502 Lakeland Blvd, Mattoon, IL 61938 | 2015-09-25 |
| 1982000139 | Judy A. Clark | Hearing Instrument Specialist | 1302 Charleston Avenue, Audibel Hearing Aids, Mattoon, IL 61938 | 2014-11-17 |
| 1023419884 | Christopher Steven Lillie | Physician Assistant | 200 Richmond Ave East, Family Medical Center, Mattoon, IL 61938 | 2014-09-11 |
| 1295055168 | Jennifer Harp | Mechanotherapist | 232 Richmond Ave East, Mattoon, IL 61938 | 2010-06-02 |
| 1447482682 | Gene Clark Hearing Aid Service | Hearing Aid Equipment | 208 Wabash, Mattoon, IL 61938 | 2009-08-21 |
| 1326229774 | Central Illinois Family Health Center | Nurse Practitioner | 10555 East County Rd 800 North, Mattoon, IL 61938 | 2007-11-14 |
| 1568656445 | Bernie Ranchero | Family Medicine | 1004 Health Center Dr Ste 210, Mattoon, IL 61938 | 2007-09-04 |
| Find all providers in zip 61938 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942500335 | Edelita Remegoso Jamis | Internal Medicine | 2512 Hurst Drive, Mattoon, IL 61938-2500 | 2010-11-01 |
| 1568657328 | Marisa Friscia | Internal Medicine | 200 Richmond Ave E Ste 1, Mattoon, IL 61938-4652 | 2007-09-13 |
| 1174733224 | Karen P. Wiarda | Internal Medicine | 100 Lerna Rd S, Cardiovascular and Thoracic Surgery, Mattoon, IL 61938-9384 | 2007-05-23 |
| 1144337767 | David Winograd | Internal Medicine | 101 Professional Plz, Mattoon, IL 61938-9252 | 2006-08-23 |
| 1003922782 | Julian Vassay | Internal Medicine | 101 Professional Plaza, Mattoon, IL 61938 | 2006-08-22 |
| 1013023449 | Alexis Ayonote | Internal Medicine | 500 Health Center Dr Ste 204, Mattoon, IL 61938-9258 | 2006-08-21 |
| 1639122922 | Robert G Good | Internal Medicine | 200 Lerna Road South, Mattoon, IL 61938 | 2006-05-18 |
| 1518408574 | Sarah Bush Lincoln Health Center | Internal Medicine | 1000 Health Center Dr, Mattoon, IL 61938-9253 | 2017-03-10 |
| 1598206682 | Sarah Bush Lincoln Health Center | Internal Medicine | 101 Professional Plz, Mattoon, IL 61938-9252 | 2017-03-09 |
| 1568818128 | Usama Bukhari | Internal Medicine | 1000 Health Center Dr, Mattoon, IL 61938-4644 | 2016-05-12 |
| Find all providers in MATTOON | ||||
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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.