DAVID JOHNSON, M.D., P. A. (NPI# 1467499418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467499418 |
| Entity Type | Organization |
| Organization Name | DAVID JOHNSON, M.D., P. A. |
| Practice Address |
775 Pole Line Rd W Suite 213 Twin Falls ID 83301-5814 |
| Practice Telephone | 2088148475 |
| Practice Fax Number | 2087344177 |
| Mailing Telephone | 2088148475 |
| Mailing Fax Number | 2087344177 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2013-03-09 |
| Authorized Official Name | DAVID A JOHNSON (PHYSICIAN) |
| Authorized Official Telephone | 2088147150 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
M9086 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 003760400 | 05 | |
| ID | RR MEDICARE | 020051471 | 01 |
| Street Address |
775 POLE LINE RD W SUITE 213 |
| City | TWIN FALLS |
| State | ID |
| Zip Code | 83301-5814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669443909 | Brad Q Starley | Internal Medicine | 775 Pole Line Rd W, Suite 203, Twin Falls, ID 83301-5814 | 2006-01-26 |
| 1750900320 | Brandy Ann Jones | Nurse Practitioner | 775 Pole Line Rd W, Twin Falls, ID 83301-5814 | 2020-04-13 |
| 1780115048 | Casie Spearing | Nurse Practitioner | 775 Pole Line Rd W, #112, Twin Falls, ID 83301-5814 | 2017-03-27 |
| 1376084673 | Marci Ahlquist | Nurse Practitioner | 775 Pole Line Rd W, Suite 203, Twin Falls, ID 83301-5814 | 2017-03-20 |
| 1457704249 | Briana O'donnell | Nurse Practitioner | 775 Pole Line Rd W, Suite 112, Twin Falls, ID 83301-5814 | 2016-07-18 |
| 1689020422 | St. Luke's Magic Valley Medical Center | General Acute Care Hospital | 775 Pole Line Rd W, Twin Falls, ID 83301-5814 | 2016-05-11 |
| 1578919932 | Jennifer Renee Rosa | Occupational Therapist | 775 Pole Line Rd W, Twin Falls, ID 83301-5814 | 2016-05-04 |
| 1346635463 | Tina M. Peer | Nurse Practitioner | 775 Pole Line Rd W, Suite 302, Twin Falls, ID 83301-5814 | 2015-04-06 |
| 1942601232 | Brenda O'neil | Physical Therapist | 775 Pole Line Rd W, Suite 307, Twin Falls, ID 83301-5814 | 2014-09-06 |
| 1891114666 | Jonathan Randolph King | Internal Medicine | 775 Pole Line Rd W, Suite 312, Twin Falls, ID 83301-5814 | 2014-04-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023645918 | Matthew Anderson | Pharmacist | Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 | 2020-03-23 |
| 1780146316 | Frontier Pediatric Partners, Pllc | Pediatrics | 1502 Locust Street N #700, Twin Falls, ID 83301 | 2019-04-02 |
| 1972073377 | Wood River Acupuncture | Acupuncturist | 1625 Addison Ave East, Twin Falls, ID 83301 | 2018-11-28 |
| 1235629874 | Lonnie Paul | Counselor | 1092 Eastland Dr N Ste A, Twin Falls, ID 83301 | 2018-05-17 |
| 1679060966 | Christina Jirapha Thongdee | Social Worker | 625 Poleline Road West, Suite 2a, Twin Falls, ID 83301 | 2018-04-23 |
| 1437658499 | Tyrel Kevin Ward | Chiropractor | 2167 Village Park Ave., Suite 100, Twin Falls, ID 83301 | 2018-02-06 |
| 1851836381 | Tanabell Health Services, Inc | Skilled Nursing Facility | 1134 Cheney Drive West, Twin Falls, ID 83301 | 2016-12-19 |
| 1578005195 | Matthew Carter | Physical Therapist | 1053 Eastland Drive, Twin Falls, ID 83301 | 2016-11-14 |
| 1790227783 | Murvat Usmanova | Nurse Practitioner | 775 Pole Line Road W, Suite 203, Twin Falls, ID 83301 | 2016-11-08 |
| 1265894687 | Shawna Fultz | Social Worker | 1201 Fall Ave East Suite C, Twin Falls, ID 83301 | 2016-03-24 |
| Find all providers in zip 83301 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922035104 | David A Johnson | Surgery | 775 Pole Line Rd W, Suite 213, Twin Falls, ID 83301-5814 | 2006-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770529240 | Wes Jon Arlein | Surgery | 700 W Ironwood Dr Ste 350, Coeur D Alene, ID 83814 | 2006-06-21 |
| 1598717985 | Michael J. Tullis | Surgery | 3875 E Overland Rd Ste 2d, Meridian, ID 83642-9005 | 2006-05-16 |
| 1598726960 | Christopher M Alessi | Surgery | 6140 W Curtisian Ave Ste 400, Boise, ID 83704-8907 | 2006-03-28 |
| 1598767196 | Douglas R Stafford | Surgery | 2109 N Main St, Coeur D Alene, ID 83814 | 2005-08-12 |
| 1164426771 | Gregory R. Hodson | Surgery | 2225 Teton Plz, Ste B, Idaho Falls, ID 83404-6494 | 2005-06-10 |
| 1609346303 | Superior Vein Care, Pllp | Surgery | 3875 E Overland Rd Ste 2d, Meridian, ID 83642-9005 | 2018-11-26 |
| 1033608161 | Alessi Vascular Surgery PC | Surgery | 6140 W Curtisian Ave Ste 400, Boise, ID 83704-8907 | 2018-05-03 |
| 1043527286 | Graham W Donald | Surgery | 6140 W Curtisian Ave, Ste 102, Boise, ID 83704 | 2010-09-09 |
| 1659699841 | St Luke's Regional Medical Center | Surgery | 333 N 1st St, Ste 280, Boise, ID 83702-6100 | 2010-05-12 |
| 1043322811 | Laser and Vein Center Pllc | Surgery | 608 Northwest Blvd, Suite 301, Coeur D Alene, ID 83814-2174 | 2006-08-31 |
| Find all providers with the same taxonomy | ||||
| City | TWIN FALLS |
| Zip Code | 83301 |
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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.