JEFFREY L JOHNSON (NPI# 1609887801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609887801 |
| Entity Type | Individual |
| Full Name | JEFFREY L JOHNSON |
| Credential | PA |
| Practice Address |
3217 W Bavaria Street Eagle ID 83616 |
| Mailing Address |
3340 E Goldstone Way Meridian ID 83642-1026 |
| Practice Telephone | 2082391000 |
| Practice Fax Number | 2082392136 |
| Mailing Telephone | 2082866676 |
| Mailing Fax Number | 2089473419 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2013-12-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA416 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114570652 | Jeffrey C. Johnson | Dentist | 250 Route 4 Ste 101, Hagatna, GU 96910-7110 | 2019-07-23 |
| 1144725391 | Jeffrey Phillip Johnson | Speech-Language Pathologist | 635 Commonwealth Ave Rm 326, Boston, MA 02215-1605 | 2018-03-29 |
| 1730684903 | Jeffrey Pace Johnson | Student in an Organized Health Care Education/Training Program | 750 E Adams St Rm 1816, Syracuse, NY 13210-2306 | 2018-03-28 |
| 1992256374 | Jeffrey S. Johnson | Counselor | 108 Okemos St, Mason, MI 48854-1263 | 2016-10-20 |
| 1598156713 | Jeffrey Johnson | Counselor | 3057 Acushnet Ave, New Bedford, MA 02745-3636 | 2015-02-10 |
| 1336542885 | Jeffrey Johnson | Physical Therapy Assistant | 563 S Grant St, Denver, CO 80209-4105 | 2014-09-29 |
| 1992110894 | Jeffrey Johnson | Dentist | 2120 Virginia Dr, Wichita Falls, TX 76309-4646 | 2014-06-30 |
| 1093125916 | Jeffrey William Johnson | Psychologist | 105 High Street, Warren, OH 44483-5195 | 2014-04-30 |
| 1922373851 | Jeffrey A. Johnson | Social Worker | 28 Roe Ln, Howell, NJ 07731-9071 | 2012-03-10 |
| 1962776039 | Jeffrey Johnson | Veterinarian | 1405 Bradford Way, Redding, CA 96003-4074 | 2012-03-06 |
| Street Address |
3217 W BAVARIA STREET |
| City | EAGLE |
| State | ID |
| Zip Code | 83616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063402097 | Arthur C Jones Iv | Family Medicine | 3217 W Bavaria Street, Eagle, ID 83616 | 2005-10-21 |
| 1316236466 | Erika Aragona | Family Medicine | 3217 W Bavaria Street, Eagle, ID 83616 | 2011-03-29 |
| 1629228978 | Talia M Sierra | Physician Assistant | 3217 W Bavaria Street, Eagle, ID 83616 | 2008-09-23 |
| 1295998862 | Daniela Grigore | Pediatrics | 3217 W Bavaria Street, Eagle, ID 83616 | 2008-07-03 |
| 1699721837 | Carrie Ann Humphrey | Pediatrics | 3217 W Bavaria Street, Eagle, ID 83616 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730714049 | Care Medical Housecalls PC | Nurse Practitioner | 2040 E Holgate Ct, Eagle, ID 83616 | 2020-03-06 |
| 1629613823 | Counseling Solutions Center LLC | Marriage & Family Therapist | 2618 East Snocreek, Eagle, ID 83616 | 2019-11-12 |
| 1245726918 | Tracy Lyn Hagadorn | Midwife | 182 State Street, Eagle, ID 83616 | 2018-07-06 |
| 1861922627 | Nicholas A. Stelzner | Counselor | 2419 W. State St. Suite 8, Boise, ID 83616 | 2017-06-14 |
| 1184080210 | Gabriel Guerrero | Dermatology | 323 E Riverside Dr Ste 234, Eagle, ID 83616 | 2016-01-05 |
| 1376940668 | Cecilia Jo Hickam | Dental Hygienist | 1121 E. State Street, Suite - 102-d, Eagle, ID 83616 | 2014-12-02 |
| 1871912634 | Christine E Birch | Psychiatry & Neurology | 1032 S Bridgeway Pl Ste 110, Eagle, ID 83616 | 2014-04-09 |
| 1043552524 | Tori Croshaw | Social Worker | 372 S Eagle Rd Ste 190, Eagle, ID 83616 | 2013-03-21 |
| 1053650010 | Kellie Ann Northam | Nurse Practitioner | 192 West State Street, Eagle, ID 83616 | 2013-02-11 |
| 1437494457 | Mary Beth Roehling | Nurse Practitioner | 2040 E Hologate Ct, Eagle, ID 83616 | 2012-12-03 |
| Find all providers in zip 83616 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801370945 | Bryan David Harr | Physician Assistant | 1675 E Riverside Dr, Eagle, ID 83616-6237 | 2018-09-24 |
| 1619495033 | Myles Cox Sibley | Physician Assistant | 377 Sylvan Lake Rd Ste 210, Eagle, CO 81631-6779 | 2017-09-06 |
| 1346791613 | Kristen Leenhouts | Physician Assistant | 2582 N Eagle Rd, Eagle, ID 83616-3650 | 2016-10-20 |
| 1952441305 | Kellee J Crockett | Physician Assistant | 1032 S Bridgway Pl, Suite 100, Eagle, ID 83616 | 2007-02-07 |
| 1891206777 | Jessica Lee Wohlschlegel | Physician Assistant | 323 E Riverside Dr Ste 224, Eagle, ID 83616-6865 | 2017-10-18 |
| 1346647526 | Bradley Morris | Physician Assistant | 3217 W Bavaria St, Eagle, ID 83616-5171 | 2014-12-03 |
| 1245536119 | Rebecca C Urquhart | Physician Assistant | 377 Sylvan Lake Rd, Eagle, CO 81631 | 2011-02-09 |
| 1326357070 | Amber Ann Hackenberg | Physician Assistant | 323 E Riverside Drive, Ste 224, Eagle, ID 83616 | 2010-09-29 |
| 1588987309 | Andrew Reed Crawford | Physician Assistant | 3217 W Bavaria St, Eagle, ID 83616-5171 | 2010-03-08 |
| 1447483086 | Matthew Valley | Physician Assistant | 1605 E Riverside Dr, Eagle, ID 83616-6237 | 2009-08-31 |
| Find all providers in EAGLE | ||||
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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.