DR. MARVIN WADE JOHNSON SR. (NPI# 1346244092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346244092 |
| Entity Type | Individual |
| Full Name | DR. MARVIN WADE JOHNSON SR. |
| Credential | M.D. |
| Practice Address |
850 E Main St Lot 1 Lake Butler FL 32054-1348 |
| Mailing Address |
Po Box 478 Lake Butler FL 32054-0478 |
| Practice Telephone | 3864962406 |
| Practice Fax Number | 3864963362 |
| Mailing Telephone | 3864962406 |
| Mailing Fax Number | 3864963362 |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2010-06-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME0011466 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 065935500 | 05 | |
| FL | BCBS | 53331 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225046881 | Marvin John Johnson | Dentist | 1046 Ne 3rd St, Mcminnville, OR 97128-4418 | 2006-08-03 |
| 1417021635 | Marvin A. Johnson | Social Worker | 27750 W Il Route 22, Suite 220, Barrington, IL 60010-2379 | 2006-11-20 |
| Street Address |
850 E MAIN ST LOT 1 |
| City | LAKE BUTLER |
| State | FL |
| Zip Code | 32054-1348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265979041 | Marvin W. Johnson M.d. | Family Medicine | 850 E Main St, Lake Butler, FL 32054-1353 | 2017-01-31 |
| 1700161205 | Debbie O'reilly Pyles | Occupational Therapist | 850 E Main St, Lake Butler, FL 32054-1353 | 2011-10-15 |
| 1851508782 | Nancy Mcginnis Haynes | Psychologist | 850 E Main St, Lake Butler, FL 32054-1353 | 2007-05-17 |
| 1205976412 | Patrick Claude Frisbee | Physician Assistant | 850 E Main St, Lake Butler, FL 32054-1353 | 2007-02-07 |
| 1013972272 | Medlink Management Services Inc | General Acute Care Hospital | 850 E Main St, Lake Butler, FL 32054 | 2006-04-19 |
| 1740253780 | Carolyn L Deloache | Nurse Practitioner | 850 E Main St, Lake Butler, FL 32054-1353 | 2006-02-09 |
| 1760465744 | Kelly Melinda Chewning | Registered Nurse | 850 E Main St, Lake Butler, FL 32054-1353 | 2005-11-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740627892 | Nalini Anandjiwala | General Practice | 7765 County Rd 231, Lake Butler, FL 32054 | 2013-05-30 |
| 1356690721 | Cheryl Anderson | Nurse Practitioner | 850 East Main Street, Lake Butler, FL 32054 | 2012-08-31 |
| 1891007860 | Lisa Cunningham | Speech-Language Pathologist | 6398 South West State Road 121, Lake Butler, FL 32054 | 2010-07-07 |
| 1609374131 | Michele Lewis | Counselor | 10 W Main St, Lake Butler, FL 32054 | 2018-01-30 |
| 1144756735 | Kateena James | Counselor | 10 W Main St, Lake Butler, FL 32054 | 2017-05-03 |
| 1710380373 | Ashley C Nelson | Counselor | 10 W Main St, Lake Butler, FL 32054 | 2014-09-26 |
| 1073954046 | Can Trong Tran | General Practice | 7765 County Rd 231, Rmc, Lake Butler, FL 32054 | 2013-07-08 |
| 1760689400 | Marta Anisia Castillo | General Practice | 7765 S County Road 231, Lake Butler, FL 32054 | 2007-06-27 |
| 1922105360 | Waldemar Ricardo Riefkohl | Dentist | Reception and Medical Center, Hwy 231, Lake Butler, FL 32054-0628 | 2006-09-20 |
| 1215351606 | Pablo Manaronsong Lomangcolob Jr. | Clinical Medical Laboratory | 7765 S County Road 231, Lake Butler, FL 32054-0628 | 2014-02-06 |
| Find all providers in zip 32054 | ||||
| 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 |
|---|---|---|---|---|
| 1265979041 | Marvin W. Johnson M.d. | Family Medicine | 850 E Main St, Lake Butler, FL 32054-1353 | 2017-01-31 |
| 1366889040 | New River Community Health Care, Inc | Family Medicine | 495 E Main St, Lake Butler, FL 32054-1731 | 2013-06-04 |
| 1669660965 | Martha Regina Lloyd | Family Medicine | 675 E Main St, Lake Butler, FL 32054-1352 | 2007-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841891777 | Medical Risk Solutions LLC | Family Medicine | 455 Ishie Ave, Bronson, FL 32621-6204 | 2020-11-06 |
| 1801497953 | Wildwood Primary Care Associates | Family Medicine | 5814 Seven Mile Dr Ste 105, Wildwood, FL 34785-8869 | 2020-11-05 |
| 1053912238 | New Port Richey Primary Care Associates | Family Medicine | 4772 Us Highway 19, New Port Richey, FL 34652-4944 | 2020-11-04 |
| 1053912550 | Wound Integrity Florida Pa | Family Medicine | 111 Ne 1st St # 1011, Miami, FL 33132-2506 | 2020-11-03 |
| 1902407455 | Trek Healthcare LLC | Family Medicine | 11767 S Dixie Hwy # 208, Pinecrest, FL 33156-4438 | 2020-11-02 |
| 1700486933 | Orlando Jorge Diaz | Family Medicine | 6231 Sw 138th Ct Apt N, Miami, FL 33183-2095 | 2020-10-27 |
| 1255930871 | Haymee Rodriguez | Family Medicine | 18751 Sw 295th Ter, Homestead, FL 33030-2310 | 2020-10-23 |
| 1033718986 | Jason Wittlin | Family Medicine | 601 Sw 242nd Ter, Newberry, FL 32669-4495 | 2020-10-21 |
| 1457950420 | Paxton Medical Management | Family Medicine | 14279 Tamiami Trl, North Port, FL 34287-2215 | 2020-10-21 |
| 1679172779 | Flagler Family Nursing Home Care LLC | Family Medicine | 130 Healthpark Blvd, St Augustine, FL 32086-5776 | 2020-10-20 |
| Find all providers with the same taxonomy | ||||
| City | LAKE BUTLER |
| Zip Code | 32054 |
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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.