DR. JOHNATHON DAVID JUSTICE (NPI# 1437419801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437419801 |
| Entity Type | Individual |
| Full Name | DR. JOHNATHON DAVID JUSTICE |
| Credential | M.D. |
| Practice Address |
704 S Clark St Thorp WI 54771-7624 |
| Practice Telephone | 7156697279 |
| Mailing Telephone | 7156697279 |
| Enumeration Date | 2012-05-20 |
| Last Update Date | 2015-07-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 64039 | WI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | WI STATE LIC | 64039 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477704211 | Johnathon Justice | Case Manager/Care Coordinator | 9500 Haven Ave, Suite #100, Rancho Cucamonga, CA 91730-5807 | 2008-10-09 |
| Street Address |
704 S CLARK ST |
| City | THORP |
| State | WI |
| Zip Code | 54771-7624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679552988 | Thomas E Looze | Internal Medicine | 704 S Clark St, Thorp, WI 54771-7624 | 2006-01-13 |
| 1750543161 | Vinay Sharma | Family Medicine | 704 S Clark St, Thorp, WI 54771-7624 | 2008-06-26 |
| 1750580213 | Pundeep Kahlon | Family Medicine | 704 S Clark St, Thorp, WI 54771-7624 | 2007-07-15 |
| 1770669392 | Marshfield Clinic | Durable Medical Equipment & Medical Supplies | 704 S Clark St, Thorp, WI 54771-7624 | 2006-10-27 |
| 1780663989 | Ascension Our Lady of Victory Hospital, Inc. | Clinic/Center | 704 S Clark St, Thorp, WI 54771-7624 | 2006-01-16 |
| 1508845827 | Peter P Gintner | Physician Assistant | 704 S Clark St, Thorp, WI 54771-7624 | 2006-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902851108 | Thorp Area Ambulance District | Ambulance | 101 S Wilson, Thorp, WI 54771 | 2006-05-24 |
| 1649332230 | Bruce Glen Campbell | Chiropractor | 102 E Main St, Thorp, WI 54771 | 2006-12-14 |
| 1649239179 | William Robert Sprague | Optometrist | 102 E Stanley St, Thorp, WI 54771 | 2006-03-22 |
| 1073815627 | Laurie K Thain | Registered Nurse | N15065 Dickerson Ave, Thorp, WI 54771-7310 | 2010-12-01 |
| 1790045904 | Mennonite Dental Clinic | Clinic/Center | W8180 County Road X, Thorp, WI 54771-7512 | 2012-05-22 |
| 1063584225 | Debra A Koltis | Counselor | W10274 Eddy Rd, Thorp, WI 54771-7626 | 2006-11-14 |
| 1861050395 | Aleyna Goerlitz | Physical Therapist | 205 E Hill St, Thorp, WI 54771-7630 | 2019-05-30 |
| 1649424383 | Hank's Furniture & Carpeting, Inc | Durable Medical Equipment & Medical Supplies | 104 S Washington St, Thorp, WI 54771-9240 | 2008-11-07 |
| 1205212156 | Thorp Family Chiropractic LLC | Chiropractor | 204 W Prospect St, Thorp, WI 54771-9303 | 2015-08-03 |
| 1518177674 | Thorp Nursing Home, Inc | Skilled Nursing Facility | 206 W Prospect St, Thorp, WI 54771-9303 | 2007-05-23 |
| Find all providers in zip 54771 | ||||
| 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 |
|---|---|---|---|---|
| 1750543161 | Vinay Sharma | Family Medicine | 704 S Clark St, Thorp, WI 54771-7624 | 2008-06-26 |
| 1750580213 | Pundeep Kahlon | Family Medicine | 704 S Clark St, Thorp, WI 54771-7624 | 2007-07-15 |
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| 1275159998 | Beam Healthcare, Sc | Family Medicine | 25 W Main St Fl 5, Madison, WI 53703-3399 | 2020-06-18 |
| 1487283503 | Enitza Damaris George | Family Medicine | 1906 Brackett Ave, Eau Claire, WI 54701-5042 | 2020-04-02 |
| 1093341380 | Tia Marie Vaccaro | Family Medicine | 1275 Judd Rd, Oregon, WI 53575-2573 | 2020-03-18 |
| 1134753411 | Proactive Md Sc,p.a. | Family Medicine | Brakebush Health Center, N4993 6th Dr., Westfield, WI 53964 | 2020-02-26 |
| 1790323608 | Solidaritus Health Wisconsin Sc | Family Medicine | 1476 Blazing Star Blvd Ste 4, Altoona, WI 54720-4002 | 2019-12-11 |
| 1255974952 | Integrative Health Center of Central Wisconsin LLC | Family Medicine | 3205 E Washington Ave Ste A, Madison, WI 53704-4332 | 2019-10-25 |
| 1962969220 | Paladina Health, LLC | Family Medicine | Paladina Health Menomonee Falls, N84 W15787 Menomonee Avenue Suite 6, Menomonee Falls, WI 53051 | 2019-02-22 |
| 1942767298 | Paladina Health, LLC | Family Medicine | Paladina Health Sussex Beer Capitol Clinic, W222 N5700 Miller Way, Sussex, WI 53069 | 2019-02-22 |
| 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.