MICHAEL JOHNSON (NPI# 1619917986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619917986 |
| Entity Type | Individual |
| Full Name | MICHAEL JOHNSON |
| Credential | PA-C |
| Practice Address |
4069 Lake Dr Se S-313 Grand Rapids MI 49546-8816 |
| Mailing Address |
100 Michigan St Ne Mc845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6167749333 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2011-01-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601002669 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MEDICARE PTAN | 0N38550 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326655150 | Michael Johnson | Massage Therapist | 4344 Promenade Way Unit 304, Marina Del Rey, CA 90292-6293 | 2020-09-25 |
| 1184236648 | Michael L Johnson | Massage Therapist | 5 Skinner Ct, Tomkins Cove, NY 10986-1105 | 2020-08-17 |
| 1902440266 | Michael Cottrell Johnson | Technician | 3812 W. Mercer Way, Mercer Island, WA 98040 | 2019-10-30 |
| 1235772658 | Michael James Johnson | Driver | 173 S 197th Dr, Buckeye, AZ 85326-3069 | 2019-10-18 |
| 1992287130 | Michael Ray Johnson | Counselor | 900 Nw 31 Ave, Suite #2000, Ft Laud, FL 33311 | 2018-09-04 |
| 1932681715 | Michael Kenneth Johnson | Physician Assistant | 5399 Coachman Rd Apt E, Columbus, OH 43220-6270 | 2018-08-29 |
| 1538648860 | Michael Darnel Johnson Sr. | Counselor | 1705 Kinser Ct, Chesapeake, VA 23324-2332 | 2018-08-08 |
| 1821584988 | Michael Todd Johnson | Registered Nurse | 2137 W 70 S, Hurricane, UT 84737-2791 | 2018-07-02 |
| 1003313727 | Michael Olton Johnson | Physician Assistant | 11513 Merrick Blvd, Jamaica, NY 11434 | 2018-04-09 |
| 1578067336 | Michael Everett Johnson | Student in an Organized Health Care Education/Training Program | 1840 E Woodchase Dr, Baton Rouge, LA 70808-4000 | 2018-03-19 |
| Street Address |
4069 LAKE DR SE S-313 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-8816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811983000 | Spectrum Health | Durable Medical Equipment & Medical Supplies | 4069 Lake Dr Se, Suite 210, Grand Rapids, MI 49546-8816 | 2005-09-22 |
| 1184070807 | Danielle Wentworth | Audiologist | 4069 Lake Dr Se, Suite 315, Grand Rapids, MI 49546-8816 | 2016-05-12 |
| 1205253424 | Elizabeth House | Physician Assistant | 4069 Lake Dr Se, Suite 312, Grand Rapids, MI 49546-8816 | 2014-03-26 |
| 1043655780 | Spectrum Health Primary Care Partners | Nutritionist | 4069 Lake Dr Se, Ste. 315, Grand Rapids, MI 49546-8816 | 2013-05-08 |
| 1790025898 | George Torao Sugiyama | Surgery | 4069 Lake Dr Se, Suite 312, Grand Rapids, MI 49546-8816 | 2013-02-26 |
| 1639442791 | Debra Ann West | Audiologist | 4069 Lake Dr Se, Suite 315, Grand Rapids, MI 49546-8816 | 2012-02-20 |
| 1982976924 | Ashley Lucas | Physician Assistant | 4069 Lake Dr Se, Suite 117, Grand Rapids, MI 49546-8816 | 2012-02-07 |
| 1861762122 | Carley Therese Flegler | Physician Assistant | 4069 Lake Dr Se, Suite 313, Grand Rapids, MI 49546-8816 | 2012-01-04 |
| 1013227156 | Spectrum Health Primary Care Partners | Durable Medical Equipment & Medical Supplies | 4069 Lake Dr Se, Suite 315, Grand Rapids, MI 49546-8816 | 2010-10-07 |
| 1285944322 | Spectrum Health Primary Care Partners | Durable Medical Equipment & Medical Supplies | 4069 Lake Dr Se, Suite 314, Grand Rapids, MI 49546-8816 | 2010-10-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| 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 |
|---|---|---|---|---|
| 1609473198 | Rachel M. Graziano | Physician Assistant | 18 Lowell Ave Ne, Grand Rapids, MI 49503-3760 | 2020-10-07 |
| 1811537269 | Joseph Salvatore Giovannucci | Physician Assistant | 145 Michigan St Ne Ste 2230, Grand Rapids, MI 49503-2562 | 2020-01-14 |
| 1326685686 | Mitchell Lebel | Physician Assistant | 932 Fulton St E Unit 1, Grand Rapids, MI 49503-3565 | 2019-12-05 |
| 1326680331 | Emily Wallace | Physician Assistant | 1661 Philadelphia Ave Se, Grand Rapids, MI 49507-2251 | 2019-10-10 |
| 1124688197 | Leeann Marie Kuehn | Physician Assistant | 218 Warren Ave Se, Grand Rapids, MI 49506-1582 | 2019-06-20 |
| 1770057549 | Shelby Elizabeth Hunt | Physician Assistant | 100 Michigan St Ne # Mc9017, Grand Rapids, MI 49503-2560 | 2019-01-15 |
| 1063906865 | Kimberly Eccher | Physician Assistant | 300 68th St. Se, Grand Rapids, MI 49548 | 2018-06-15 |
| 1174029094 | Katrina Ann Brummel | Physician Assistant | 555 Midtowne St Ne Ste 110, Grand Rapids, MI 49503-5731 | 2018-03-30 |
| 1902312994 | Aaron Michaud | Physician Assistant | 301 Barclay Ave Ne, Grand Rapids, MI 49503 | 2017-12-28 |
| 1538687215 | Sonia Nicola | Physician Assistant | 4100 Embassy Dr Se Ste 400, Grand Rapids, MI 49546-2416 | 2017-09-01 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
Please comment or provide details below to improve the information on MICHAEL JOHNSON.
| 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.