DR. GLENN RAY JOHNSON (NPI# 1417950569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417950569 |
| Entity Type | Individual |
| Full Name | DR. GLENN RAY JOHNSON |
| Credential | M.D. |
| Practice Address |
901 Montgomery St Decorah IA 52101-2325 |
| Mailing Address |
2215 Big Timber Rd Calmar IA 52132-7577 |
| Practice Telephone | 5633822911 |
| Practice Fax Number | 5633873102 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2015-01-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 24542 | MN | Allopathic & Osteopathic Physicians |
| Y | 207X00000X | Orthopaedic Surgery | 215501 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 1417950569 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003093683 | Glenn A. Johnson | Physical Therapist | 808 E Justin Dr, Sioux Falls, SD 57108-4646 | 2008-01-26 |
| 1225235997 | Glenn Edwin Johnson | Chiropractor | 1665 S Brookhurst St, Suite J, Anaheim, CA 92804-6000 | 2007-06-27 |
| 1063441434 | Glenn Dwight Johnson | Otolaryngology | Dartmouth-hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756-0001 | 2006-06-30 |
| 1710391719 | Glenn Johnson | Psychologist | 118 Maupin Cir, Shelbyville, TN 37160-3781 | 2014-06-17 |
| 1710249255 | Glenn Phelps Johnson Jr. | Counselor | 137 N Cottonwood St, Suite 1530, Woodland, CA 95695-6646 | 2012-06-11 |
| 1942480306 | Glenn A Johnson | Chiropractor | 500 9th Ave, Suite 5, Longmont, CO 80501-4598 | 2007-11-13 |
| 1609909829 | Glenn Roger Johnson | Psychologist | 256 Concord Ave, Cambridge, MA 02138-1337 | 2007-03-14 |
| 1265583751 | Glenn D Johnson | Chiropractor | 10321 Kingston Pike, Knoxville, TN 37922-3224 | 2007-01-13 |
| 1508958281 | Glenn Everett Johnson | Dentist | 2478 Patterson Road, Suite 24, Grand Junction, CO 81505 | 2006-09-29 |
| 1710929765 | Glenn Albert Johnson | Speech-Language Pathologist | 2611 Ne 125th St, Suite 225, Seattle, WA 98125-4373 | 2006-06-12 |
| Street Address |
901 MONTGOMERY ST |
| City | DECORAH |
| State | IA |
| Zip Code | 52101-2325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992311708 | Colleen Clement | Pharmacist | 901 Montgomery St, Decorah, IA 52101-2325 | 2020-09-17 |
| 1780221986 | Christina A Schultz | Physical Therapist | 901 Montgomery St, Decorah, IA 52101-2325 | 2019-12-06 |
| 1336786532 | Chelsey Bohr | Physical Therapist | 901 Montgomery St, Decorah, IA 52101-2325 | 2019-12-06 |
| 1215572268 | Heather Kay Levinson | Nurse Practitioner | 901 Montgomery St, Decorah, IA 52101-2325 | 2019-11-14 |
| 1295380400 | Jennifer Marie Becker | Family Medicine | 901 Montgomery St, Decorah, IA 52101-2325 | 2019-08-05 |
| 1154802601 | Jason Engelken | Physical Therapist | 901 Montgomery St, Decorah, IA 52101-2325 | 2018-08-23 |
| 1649763889 | Tiffany R Zweibohmer | Registered Nurse | 901 Montgomery St, Decorah, IA 52101-2325 | 2018-06-12 |
| 1891211967 | Carol Ludeking | Nurse Practitioner | 901 Montgomery St, Decorah, IA 52101-2325 | 2017-08-20 |
| 1700316254 | Miranda Lynn Hayek | Occupational Therapist | 901 Montgomery St, Decorah, IA 52101-2325 | 2017-06-18 |
| 1750811212 | Dennis A Keefe | Physical Therapist | 901 Montgomery St, Decorah, IA 52101-2325 | 2017-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841757911 | Andrew W Fritz | Specialist/Technologist | 700 College Drive, Regents Center, Decorah, IA 52101 | 2019-02-26 |
| 1265846935 | Amber Lynn Mccarville | Dentist | 501 Sanford, Decorah, IA 52101 | 2014-06-20 |
| 1669893988 | Winneshiek Medical Center | Clinic/Center | 112 East Main St., Ossian, IA 52101 | 2014-01-06 |
| 1467589317 | Brenda Harris | Acupuncturist | 309 West Broadway Street, Decorah, IA 52101 | 2007-02-27 |
| 1487721809 | Mary Christine Atkinson | Counselor | 1111 Paine Street, Decorah, IA 52101 | 2006-11-29 |
| 1578632220 | Kirsten Ann Ludwig | Counselor | 1111 Paine St, Decorah, IA 52101 | 2006-11-07 |
| 1760585350 | Dental Associates of Decorah PC | Dentist | 501 Sanford St, Decorah, IA 52101 | 2006-09-07 |
| 1780634196 | Theresa K Fullhart | Social Worker | 905 Montgomery Street, Decorah, IA 52101 | 2006-05-10 |
| 1487620688 | Mayo Clinic Hospital-rochester | Clinic/Center | 901 Montgomery Street, Decorah, IA 52101 | 2006-02-27 |
| 1932588100 | Elizabeth L Abbas | Family Medicine | 1830 State Highway 9, Decorah, IA 52101 | 2015-05-21 |
| Find all providers in zip 52101 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295796795 | Bruce W Wulfsberg | Orthopaedic Surgery | 901 Montgomery St, Decorah, IA 52101-2325 | 2006-04-01 |
| 1528061264 | Ricky Duane Wilkerson | Orthopaedic Surgery | 901 Montgomery St, Decorah, IA 52101 | 2005-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740660802 | Mercy Medical Center - Newton | Orthopaedic Surgery | 300 N 4th Ave E Ste C, Newton, IA 50208-3155 | 2015-06-04 |
| 1891057550 | Cnos, PC | Orthopaedic Surgery | 2735 Outer Drive N, Sioux City, IA 51104-1590 | 2012-06-08 |
| 1568730323 | Jonathan D Winston | Orthopaedic Surgery | 2300 53rd Ave Ste 100, Bettendorf, IA 52722-7565 | 2011-12-08 |
| 1770874034 | Megan Crosmer | Orthopaedic Surgery | 3385 Dexter Ct Ste 300, Davenport, IA 52807-3471 | 2011-04-21 |
| 1457672719 | Paul Butler | Orthopaedic Surgery | 350 Ne 36th St Ste 213, Ankeny, IA 50021-6728 | 2010-06-21 |
| 1164690574 | Md West One, PC | Orthopaedic Surgery | 201 Ridge St Ste 311, Council Bluffs, IA 51503-4643 | 2008-02-19 |
| 1487849527 | Joseph Albert Brunkhorst IIi | Orthopaedic Surgery | 350 Ne 36th St, Ankeny, IA 50021-6728 | 2007-09-12 |
| 1942409172 | David S. Tearse M.d., LLC | Orthopaedic Surgery | 112 14th St Se, Cedar Rapids, IA 52403-4025 | 2007-07-17 |
| 1134334006 | Jason Stanford | Orthopaedic Surgery | 516 Division St Ste 125, Cedar Falls, IA 50613-2380 | 2007-05-13 |
| 1982756284 | The Grinnell Institute for Bone Health | Orthopaedic Surgery | 810 Commercial St., Grinnell, IA 50112 | 2007-01-17 |
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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.