DR. MICHAEL THOMAS JOHNSON (NPI# 1811308588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811308588 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL THOMAS JOHNSON |
| Credential | M.D. |
| Practice Address |
3264 N Evergreen Dr Ne Grand Rapids MI 49525-9746 |
| Practice Telephone | 6163637272 |
| Practice Fax Number | 6163615828 |
| Mailing Telephone | 6163637272 |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2020-06-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
4301501433 | MI | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
269258 | MA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| 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 |
3264 N EVERGREEN DR NE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49525-9746 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720081649 | Jay A Harolds | Radiology | 3264 N Evergreen Dr Ne, Grand Rapids, MI 49525-9746 | 2005-05-24 |
| 1932768058 | Spartan Radiology, Inc | Radiology | 3264 N Evergreen Dr Ne, Grand Rapids, MI 49525-9746 | 2019-06-12 |
| 1346737970 | Laura Lynn Phillips | Nurse Practitioner | 3264 N Evergreen Dr Ne, Grand Rapids, MI 49525-9746 | 2018-04-19 |
| 1457724965 | Kwabea E Agbley | Physician Assistant | 3264 N Evergreen Dr Ne, Grand Rapids, MI 49525-9746 | 2015-11-05 |
| 1104293646 | Lauren R Haskin | Physician Assistant | 3264 N Evergreen Dr Ne, Grand Rapids, MI 49525 | 2015-09-01 |
| 1356743959 | Alicia Hock | Nurse Practitioner | 3264 N Evergreen Dr Ne, Grand Rapids, MI 49525-9746 | 2014-09-25 |
| 1063821056 | Jeanette Lynn Quick | Nurse Practitioner | 3264 N Evergreen Dr Ne, Grand Rapids, MI 49525-9746 | 2014-08-05 |
| 1881006823 | David Mitchell | Radiology | 3264 N Evergreen Dr Ne, Grand Rapids, MI 49525-9746 | 2014-05-26 |
| 1699185561 | Michael Vincent Perone | Radiology | 3264 N Evergreen Dr Ne, Grand Rapids, MI 49525-9746 | 2014-05-01 |
| 1902225337 | Stephen Russell Vossler | Radiology | 3264 N Evergreen Dr Ne, Grand Rapids, MI 49525-9746 | 2014-04-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928507 | Therapy With Nicole Pllc | Community/Behavioral Health | 4867 E. Beltline Ave. Ne, Building #1 Lower Level, Grand Rapids, MI 49525 | 2020-09-29 |
| 1184242760 | Christian Healthcare Specialists, Inc. | Obstetrics & Gynecology | 3322 Beltline Court Ne, Suite 1, Grand Rapids, MI 49525 | 2020-07-09 |
| 1174154645 | Amy Vanderslik | Case Manager/Care Coordinator | 3310 Eaglecrest Park Dr. Ne, Suite 100, Grand Rapids, MI 49525 | 2020-02-03 |
| 1477195246 | Epic Discoveries LLC | Counselor | 4867 E. Beltline Ave Ne, Grand Rapids, MI 49525 | 2019-10-14 |
| 1598228959 | Kim Scherencel Lmsw Counseling | Social Worker | 3280 Beltline Ne, Grand Rapids, MI 49525 | 2019-04-11 |
| 1821558958 | Mindful Trajectories | Social Worker | 3280 Beltlne Ct Ne, Grand Rapids, MI 49525 | 2019-03-24 |
| 1104380518 | Julianne Lettinga, Ma Lpc Counseling | Counselor | 3280 East Beltline Ct Ne, Grand Rapids, MI 49525 | 2019-01-30 |
| 1396227229 | Christopher Scot Doucette | Social Worker | 2064 Airway St Ne, Grand Rapids, MI 49525 | 2018-09-06 |
| 1568976017 | Amy K. Deyoung, Dds, Ms, PC Pediatric Dentistry | Dentist | 3297 Eagle Run Dr. Ne, Grand Rapids, MI 49525 | 2017-11-20 |
| 1407389604 | Kelly Jo Crabb | Social Worker | 4829 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49525 | 2017-04-05 |
| Find all providers in zip 49525 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376838698 | G Jay Rottman | Radiology | 847 Parchment Se, Dmi Clinic, Grand Rapids, MI 49546 | 2011-06-15 |
| 1144533381 | Ryan Richard Konwinski | Radiology | 100 Michigan St Ne # Mc-046, Diagnostic Radiology Residency, Grand Rapids, MI 49503-2560 | 2010-07-16 |
| 1578753489 | Jason P Dykstra | Radiology | Advanced Radiology Services P.C., 3264 N Evergreen Dr, Grand Rapids, MI 49525-9746 | 2007-07-26 |
| 1417158619 | Robert Oostveen | Radiology | 3264 N Evergreen Dr, Advanced Radiology Services P.C., Grand Rapids, MI 49525-9746 | 2007-05-29 |
| 1780801688 | James Michael Hecksel | Radiology | 3264n Evergreen Nedr, Grand Rapids, MI 49525-9746 | 2007-04-20 |
| 1881618239 | Mark David Malnor | Radiology | 200 Jeffeson Se, Grand Rapids, MI 49503 | 2006-07-27 |
| 1396745576 | Paul Norman Olson | Radiology | 111 Golf Course Rd, Grand Rapids, MN 55744-3526 | 2005-07-28 |
| 1720081649 | Jay A Harolds | Radiology | 3264 N Evergreen Dr Ne, Grand Rapids, MI 49525-9746 | 2005-05-24 |
| 1306463872 | Patrick James Gidley | Radiology | 200 Jefferson Se, Jefferson Bldg Suite 305, Grand Rapids, MI 49503 | 2020-07-01 |
| 1619593530 | Albert Dongzhou Jiao | Radiology | 200 Jefferson Ave Se, Jefferson Suite 360, Grand Rapids, MI 49503 | 2020-06-17 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49525 |
Please comment or provide details below to improve the information on DR. MICHAEL THOMAS 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.