THOMAS DWAYNE JOHNSON (NPI# 1821096421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821096421 |
| Entity Type | Individual |
| Full Name | THOMAS DWAYNE JOHNSON |
| Credential | MD |
| Practice Address |
1417 N Main St Jamestown KY 42629-2411 |
| Mailing Address |
Po Box 966 Jamestown KY 42629-0966 |
| Practice Telephone | 2703432597 |
| Practice Fax Number | 2703432598 |
| Mailing Telephone | 2703432597 |
| Mailing Fax Number | 2703432598 |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2010-05-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 37317 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | ANTHEM BC/BS | 000000294096 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881069862 | Thomas Mark Johnson | Registered Nurse | N5733 Gurholt Lake Rd, Scandinavia, WI 54977-9736 | 2015-12-02 |
| 1114339884 | Thomas Johnson | Pharmacist | 1540 W El Camino Ave, Sacramento, CA 95833-1946 | 2014-05-28 |
| 1023428471 | Thomas Johnson | Pharmacist | 2900 Biscayne Blvd, Miami, FL 33137-4122 | 2014-05-06 |
| 1588009765 | Thomas Vincent Johnson IIi | Ophthalmology | Wilmer Eye Institute, Johns Hopkins Hospital, 600 North Wolfe Street, Wilmer B-29, Baltimore, MD 21287-0001 | 2013-05-01 |
| 1982958666 | Thomas Martin Johnson | Chiropractor | 2806 Townsgate Rd Ste B, Westlake Village, CA 91361-3066 | 2012-11-02 |
| 1497013668 | Thomas Allen Johnson | Chiropractor | 446 S Mall Dr Ste B5, Saint George, UT 84790-4945 | 2012-04-25 |
| 1467731778 | Thomas Henry Johnson | Specialist/Technologist | 345 E Avenue J7, Lancaster, CA 93535-3644 | 2011-08-04 |
| 1710278320 | Thomas Duane Johnson | General Practice | 2330 Birch Rd, York, PA 17408-4107 | 2011-04-29 |
| 1912209024 | Thomas Allen Johnson | Hearing Instrument Specialist | 1428 N Woodland Blvd, Deland, FL 32720-2260 | 2010-11-22 |
| 1023346525 | Thomas J. Johnson | Specialist/Technologist, Other | 1311 Strozier Ct, Barling, AR 72923-2035 | 2009-11-23 |
| Street Address |
1417 N MAIN ST |
| City | JAMESTOWN |
| State | KY |
| Zip Code | 42629-2411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121412 | Jamestown Valu-rite Pharmacy Inc | Clinical Medical Laboratory | 1417 N Main St, Jamestown, KY 42629-2411 | 2020-10-09 |
| 1912340449 | Tamra E. Atwood | Nurse Practitioner | 1417 N Main St, Jamestown, KY 42629-2411 | 2013-04-15 |
| 1063695021 | Rch Jamestown Healthcare Lab | Clinical Medical Laboratory | 1417 N Main St, Jamestown, KY 42629 | 2007-12-13 |
| 1275726812 | Jennifer Ashley Hart | Nurse Practitioner | 1417 N Main St, Jamestown, KY 42629-2411 | 2007-08-27 |
| 1588723241 | Jamestown Healthcare Clinic LLC | Family Medicine | 1417 N Main St, Jamestown, KY 42629 | 2006-12-08 |
| 1396746533 | Stephanie R Jones | Family Medicine | 1417 N Main St, Jamestown, KY 42629-2411 | 2005-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023400124 | Vickie Robertson | Registered Nurse | 119 Herriford Curve Rd, Jamestown, KY 42629 | 2015-02-26 |
| 1821314733 | Kristin Holly Adams | Pharmacist | 1417 N. Main St., Jamestown, KY 42629 | 2010-04-16 |
| 1588989008 | Jamestown Healthcare Clinic, LLC | Nurse Practitioner | 1417 N. Main St, Jamestown, KY 42629 | 2010-03-29 |
| 1801079660 | Lynda K Heath | Nurse Practitioner | 119 Hereford Curve Rd, Jamestown, KY 42629 | 2007-12-14 |
| 1609064831 | Julene Hopper | Counselor | 119 Hereford Curve Road, Jamestown, KY 42629 | 2007-10-12 |
| 1114059375 | Lisa Ann Helm | Speech-Language Pathologist | 70 Forest Hill Drive, Jamestown, KY 42629 | 2007-03-12 |
| 1235268723 | Jamestown Valu-rite Pharmacy | Durable Medical Equipment & Medical Supplies | 1417 North Main Street, Suite A, Jamestown, KY 42629 | 2007-03-02 |
| 1972642361 | Russell County Board of Education | Local Education Agency (LEA) | 404 S Main Street, Jamestown, KY 42629 | 2007-02-05 |
| 1508942749 | Melanie K Loy Flanagan | Dentist | 43 Fruit of The Loom Drive, Jamestown, KY 42629 | 2006-10-31 |
| 1891881413 | Jeffrey Louis Warner | Pharmacist | 1417 N. Main Street, Suite A, Jamestown, KY 42629 | 2006-10-04 |
| Find all providers in zip 42629 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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|---|---|---|---|---|
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| 1689214454 | Superior Healthcare Pllc | General Practice | 7560 Us Highway 42 Ste B, Florence, KY 41042-1908 | 2020-01-09 |
| 1144876814 | You Only Live Once Medical | General Practice | 821 Ulrich Ave, Louisville, KY 40219-1844 | 2019-08-17 |
| 1760979124 | Healthy Living Primary Care | General Practice | 4400 Breckenridge Ln Ste 147, Louisville, KY 40218 | 2018-04-20 |
| 1649775586 | Landmark Medical of Kentucky, Psc | General Practice | 113 Glenn Pl Unit 100, Lexington, KY 40505-3518 | 2018-03-23 |
| 1639603145 | Charita Weathers | General Practice | 401 East Chestnut, Ste 610, Louisville, KY 40202 | 2017-04-12 |
| 1881146033 | Alliance Health Care, LLC | General Practice | 1710 D State Route 121 North, Murray, KY 42071 | 2016-11-03 |
| 1528519113 | A New Journey | General Practice | 4100 Cadillac Ct, Louisville, KY 40213-1591 | 2016-10-18 |
| 1013381441 | Veloz Medical Services Corp | General Practice | 6911 Shepherdsville Rd, Louisville, KY 40219-2211 | 2015-11-23 |
| 1407229545 | Fern Medical and Rehab Corp | General Practice | 5520 Fern Valley Rd, 107, Louisville, KY 40228-1087 | 2015-11-12 |
| Find all providers with the same taxonomy | ||||
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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.