BRUCE MICHAEL JOHNSON (NPI# 1538183793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538183793 |
| Entity Type | Individual |
| Full Name | BRUCE MICHAEL JOHNSON |
| Credential | M.D. |
| Practice Address |
1600 N Grand Ave Ste 510 Pueblo CO 81003-2700 |
| Practice Telephone | 7195663535 |
| Practice Fax Number | 7195663565 |
| Mailing Telephone | 7195663535 |
| Mailing Fax Number | 7195663565 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 20619 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 01260199 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902452329 | Bruce Johnson | Technician | 1720 R St Se, Washington, DC 20020-4763 | 2019-08-12 |
| 1215304738 | Bruce A. Johnson | Marriage & Family Therapist | 425 Coon Rapids Blvd., Coon Rapids, MN 55433 | 2015-09-01 |
| 1932398393 | Bruce David Johnson | Social Worker | 230 East Marydale, Suite 2, Soldotna, AK 99669-7648 | 2007-10-22 |
| 1447453097 | Bruce G Johnson | Anesthesiology | 800 E Cheves St Ste 480b, Florence, SC 29506-2650 | 2007-06-08 |
| 1366654899 | Bruce Gordon Johnson | Optometrist | 2610 South Douglas Highway, Suite 190, Gillette, WY 82718 | 2007-05-04 |
| 1104041813 | Bruce C. Johnson | Psychiatry & Neurology | 748 Se Fairwinds Loop, Vancouver, WA 98661-8087 | 2007-04-16 |
| 1114040011 | Bruce Hinton Johnson | Dentist | 7641 Shaffer Pkwy, Littleton, CO 80127-3013 | 2007-04-08 |
| 1013034933 | Bruce Lyman Johnson | Dentist | 716 Castle Heights Ct, Lebanon, TN 37087-2670 | 2007-03-24 |
| 1912043621 | Bruce Johnson | Internal Medicine | 800 W Biesterfield Road, Suite 4003, Elk Grove Village, IL 60007 | 2007-01-29 |
| 1366591687 | Bruce A Johnson | Dentist | 8 W Dry Creek Circle, Ste 200, Littleton, CO 80120 | 2007-01-09 |
| Street Address |
1600 N GRAND AVE STE 510 |
| City | PUEBLO |
| State | CO |
| Zip Code | 81003-2700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457354763 | Hisman H Percival | Surgery | 1600 N Grand Ave, Suite 430, Pueblo, CO 81003-2700 | 2005-05-31 |
| 1710365416 | Paladina Health, LLC | Family Medicine | 1600 N Grand Ave, Suite 540, Pueblo, CO 81003-2700 | 2015-05-13 |
| 1407249188 | Christopher Traut | Neurological Surgery | 1600 N Grand Ave, Suite 508, Pueblo, CO 81003-2700 | 2015-03-05 |
| 1124423116 | Kati Jo Foechterle | Nurse Practitioner | 1600 N Grand Ave, Suite 140, Pueblo, CO 81003-2700 | 2014-11-03 |
| 1326469248 | Micah Johnson | Physician Assistant | 1600 N Grand Ave, Suite 508, Pueblo, CO 81003-2700 | 2013-12-19 |
| 1720364177 | Anesthesia Management Services, LLC | Nurse Anesthetist, Certified Registered | 1600 N Grand Ave, Suite 420, Pueblo, CO 81003-2700 | 2011-10-31 |
| 1326366105 | Rachel Christine Niemet | Obstetrics & Gynecology | 1600 N Grand Ave, Ste 400, Pueblo, CO 81003-2700 | 2010-05-04 |
| 1306081237 | Neil A Banga | Surgery | 1600 N Grand Ave, Suite 430, Pueblo, CO 81003-2700 | 2008-12-05 |
| 1174770614 | Henrique Jose Fernandez | Internal Medicine | 1600 N Grand Ave, Suite 150, Pueblo, CO 81003-2749 | 2008-08-27 |
| 1831353705 | Marcel Jabour Junqueira | Internal Medicine | 1600 N Grand Ave, Suite 140, Pueblo, CO 81003-2700 | 2008-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164042016 | Sunil Kumar | Student in an Organized Health Care Education/Training Program | Parkview Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2020-04-21 |
| 1497382303 | Pueblo Family Dentistry Pllc | Dentist | 701 N Grand Avenue, Suite B, Pueblo, CO 81003 | 2020-03-23 |
| 1023654241 | Elmer A. Villalon, Dmd, LLC | Clinic/Center | 1225 North Main Street, #207, Pueblo, CO 81003 | 2019-11-22 |
| 1518434349 | Mariam Rahim | Internal Medicine | Parkview Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2018-10-30 |
| 1003308222 | Julia Mcneice | Internal Medicine | Parkview Medial Center, Parkveiw Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2018-06-04 |
| 1689164857 | Jessica Sels | Internal Medicine | Parkview Medical Center Adult Medicine Clinic, 311 W 14th St, Pueblo, CO 81003 | 2018-05-14 |
| 1700313459 | Allison Vigil | Occupational Therapist | 1600 W. 24th St, Pueblo, CO 81003 | 2017-05-12 |
| 1245682020 | Paul S Bongat | Internal Medicine | 411 W. 14th St., Parkview Adult Medicine Clinic, Pueblo, CO 81003 | 2016-07-06 |
| 1013368596 | Daniel R Long | Internal Medicine | 411 West 14th Street, Pueblo, CO 81003 | 2016-06-27 |
| 1396195665 | Parkview Medical Center | General Acute Care Hospital | 411 W. 14th St, Pueblo, CO 81003 | 2016-06-17 |
| Find all providers in zip 81003 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 |
|---|---|---|---|---|
| 1205220530 | Priscilla Nobecourt | Surgery | 1600 N Grand Ave Ste 430, Pueblo, CO 81003-2760 | 2015-03-25 |
| 1881959005 | Srikant Sivaraman | Surgery | 1401 Court Street, Pueblo, CO 81003-2715 | 2012-07-13 |
| 1730220278 | Sandeep Suresh Vijan | Surgery | 1600 North Grand Ave. Suite 430, Pueblo, CO 81003-2760 | 2007-02-09 |
| 1851482665 | John Charles Dugal Jr. | Surgery | 1600 North Grand Ave., Suite 500, Pueblo, CO 81003-2757 | 2006-09-27 |
| 1023056173 | Paul Raymond Radway | Surgery | 3506 San Jose Ct, Pueblo, CO 81005-3916 | 2006-06-02 |
| 1164499976 | Lonnie L Imlay | Surgery | 1925 E. Orman Ave., Suite A109, Pueblo, CO 81004 | 2006-03-01 |
| 1164412862 | Kenneth Madsen | Surgery | 3530 E Spaulding Ave, Pueblo, CO 81008-2209 | 2005-10-24 |
| 1841282498 | Gary E Lane | Surgery | 1925 E Orman Ave, Suite A109, Pueblo, CO 81004-3537 | 2005-08-19 |
| 1457354763 | Hisman H Percival | Surgery | 1600 N Grand Ave, Suite 430, Pueblo, CO 81003-2700 | 2005-05-31 |
| 1285276683 | Parkview Ancillary Services | Surgery | 1600 N. Grand Ave., Ste 345, Pueblo, CO 81003-2762 | 2019-10-17 |
| Find all providers in PUEBLO | ||||
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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.