DAVID ELLSWORTH JOHNSON (NPI# 1396803763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396803763 |
| Entity Type | Individual |
| Full Name | DAVID ELLSWORTH JOHNSON |
| Credential | M.D. |
| Practice Address |
3100 Tongass Ave Ketchikan AK 99901-5746 |
| Mailing Address |
Po Box 6852 Ketchikan AK 99901-1852 |
| Practice Telephone | 9072254463 |
| Mailing Telephone | 9072256396 |
| Mailing Fax Number | 9072475951 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 1160 | AK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MD1213 | 05 | |
| AK | TRICARE | R004 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841804044 | David Johnson | Home Health Aide | 4436 Davis Grove Blvd, Olive Branch, MS 38654-5631 | 2020-09-04 |
| 1952803314 | David M Johnson | Specialist | 1345 Nw 15th St, Lincoln City, OR 97367-3327 | 2018-03-01 |
| 1932615333 | David Johnson | Hearing Instrument Specialist | 905 N Cass St, Wabash, IN 46992-1043 | 2017-12-20 |
| 1316457211 | David Johnson | Specialist/Technologist | 14354 Mission Way, Broomfield, CO 80023-4049 | 2017-10-05 |
| 1437519501 | David Hale Johnson | Nurse Practitioner | 169 Doctors Drive, Boone, NC 28607 | 2016-03-02 |
| 1366812141 | David Clayton Johnson | Occupational Therapist | 201 Ridgecrest Dr, Chapel Hill, NC 27514-2104 | 2015-10-06 |
| 1447635529 | David Johnson | Student in an Organized Health Care Education/Training Program | 9666 Kent St, Elk Grove, CA 95624 | 2015-07-30 |
| 1245623628 | David Johnson | Pharmacist | 10223 50th Ave E, Tacoma, WA 98446-5412 | 2015-03-10 |
| 1710377585 | David Jackson Johnson | Counselor | 862 S Main St Ste 2, Brigham City, UT 84302-3300 | 2015-01-30 |
| 1376892828 | David Berek Johnson | Chiropractor | 7559 Kayne Blvd, Columbus, GA 31909-2521 | 2012-08-30 |
| Street Address |
3100 TONGASS AVE |
| City | KETCHIKAN |
| State | AK |
| Zip Code | 99901-5746 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194720250 | Alan L Christensen | Obstetrics & Gynecology | 3100 Tongass Ave, Ketchikan, AK 99901-5746 | 2005-06-16 |
| 1528544822 | Peacehealth Ketchikan Medical Center | Medicare Defined Swing Bed Unit | 3100 Tongass Ave, Ketchikan, AK 99901-5746 | 2018-07-19 |
| 1710337381 | Ian Dobbe | Family Medicine | 3100 Tongass Ave, Ketchikan, AK 99901-5746 | 2016-06-15 |
| 1073977443 | Michael Sheflo | Internal Medicine | 3100 Tongass Ave, Ketchikan, AK 99901-5746 | 2016-04-11 |
| 1598144800 | Bryan Cothren | Psychiatry & Neurology | 3100 Tongass Ave, Ketchikan, AK 99901 | 2015-05-20 |
| 1093145567 | Catherine Henderson | Nurse Practitioner | 3100 Tongass Ave, Ketchikan, AK 99901-5746 | 2013-11-20 |
| 1003169434 | Urology Northwest, Ps | Urology | 3100 Tongass Ave, 3rd Floor Visiting Clinic, Ketchikan, AK 99901-5746 | 2012-10-23 |
| 1821374497 | Deborah M O'loane | Nurse Practitioner | 3100 Tongass Ave, Ketchikan, AK 99901-5746 | 2011-10-27 |
| 1215239595 | Nes Washington, Inc. | Emergency Medicine | 3100 Tongass Ave, Ketchikan, AK 99901 | 2010-11-19 |
| 1447562921 | Victor Chen | Psychiatry & Neurology | 3100 Tongass Ave, Ketchikan, AK 99901-5746 | 2010-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314215 | Residential Youth Care, Inc. | Community/Behavioral Health | 2442 Tongass Avenue, Ketchikan, AK 99901 | 2020-07-23 |
| 1316563026 | Residential Youth Care, Inc. | Community/Behavioral Health | 606 Hill Road, Ketchikan, AK 99901 | 2020-06-18 |
| 1043836851 | Residential Youth Care, Inc. | Community/Behavioral Health | 2514 1st Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1215553029 | Residential Youth Care, Inc. | Community/Behavioral Health | 2951 Baranof Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1174159222 | Helene Rae Simpson | Behavior Technician | 201 Deermont St, Ketchikan, AK 99901 | 2020-03-20 |
| 1003295155 | Suzanne Webb | Massage Therapist | 602 Dock St Ste 106, Ketchikan, AK 99901 | 2015-05-22 |
| 1093194342 | Kate Mortensen | Case Manager/Care Coordinator | 2690 Tongass Ave, Ketchikan, AK 99901 | 2015-05-20 |
| 1578879631 | Thomas Peter Ryan | Social Worker | 320 Bawden St. #318, Ketchikan, AK 99901 | 2010-08-27 |
| 1689820979 | Akeela Inc | Community Based Residential Treatment Facility, Mental Illness | 3050 Fifth Ave, Ketchikan, AK 99901 | 2008-08-18 |
| 1750565438 | Susan Marie Swift | Nurse Practitioner | 21 Jefferson Way, Suite 202, Psychiatry, Ketchikan, AK 99901 | 2007-12-18 |
| Find all providers in zip 99901 | ||||
| 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 |
|---|---|---|---|---|
| 1629543046 | Pacific Pediatrics, LLC | Pediatrics | 63 Higgins Spur, Ketchikan, AK 99901-9442 | 2018-10-11 |
| 1790996916 | Elisa Marie Rosier | Pediatrics | 212 Carlanna Lake Rd Ste 203, Ketchikan, AK 99901-5642 | 2007-05-28 |
| 1972966851 | Sean Bhagat | Pediatrics | Peacehealth Medical Group, 3100 Tongass Ave, Ketchikan, AK 99901 | 2016-03-30 |
| 1891726659 | John G Rosenfeld | Pediatrics | 3100 Tongass Ave, Ketchikan, AK 99901-5746 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780195727 | Amanda Kathleen Dunlap | Pediatrics | 3340 Providence Dr Ste A-452, Anchorage, AK 99508-4691 | 2017-10-17 |
| 1841663945 | Jennifer Elisabeth Austin | Pediatrics | 751 E 36th Ave Ste 100, Anchorage, AK 99503 | 2015-11-11 |
| 1295112159 | Jacob Eby | Pediatrics | 673 Mdg 5955 Zeamer Ave, Jber, AK 99506 | 2015-04-29 |
| 1821409137 | Denise Frohlich Jones | Pediatrics | Alaska Neonatology Assoc, 3340 Providence Dr. Suite 366, Anchorage, AK 99508 | 2014-05-08 |
| 1780003376 | Carolyn Roloff | Pediatrics | 3200 Providence Dr Fl 3, Anchorage, AK 99508 | 2014-04-10 |
| 1154755056 | Begich School Based Health Center | Pediatrics | 7440 Creekside Center Dr, Anchorage, AK 99504-5234 | 2013-08-27 |
| 1710262175 | Anchorage School Based Health Centers | Pediatrics | 150 Bragaw St, Anchorage, AK 99508-1307 | 2011-10-18 |
| 1164719423 | Scott Edward Stewart | Pediatrics | 673rd Mdg, 5955 Zeamer Ave, Jber, AK 99506 | 2011-07-06 |
| 1003142621 | Mat-su Community Pediatrics, P.C. | Pediatrics | 3750 E. Country Field Circle, Suite C, Wasilla, AK 99654 | 2009-11-02 |
| 1992936413 | J Robert Lovrich | Pediatrics | 10840 Vosikof Pl, Anchorage, AK 99507-6461 | 2009-07-31 |
| Find all providers with the same taxonomy | ||||
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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.