MR. MICHAEL JAMES JOHNSON (NPI# 1891714234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891714234 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL JAMES JOHNSON |
| Credential | PA |
| Practice Address |
1008 Minnequa Ave Pueblo CO 81004-3733 |
| Mailing Address |
445 E Cheyenne Mountain Blvd Ste C Pmb 406 Colorado Springs CO 80906-4570 |
| Practice Telephone | 7195605656 |
| Practice Fax Number | 7195604715 |
| Mailing Telephone | 7195388100 |
| Mailing Fax Number | 7195388003 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2008-01-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 595 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 07005952 | 05 | |
| CO | RAILROAD MEDICARE | 970016858 | 01 |
| CT | DEA | MJ0200763 | 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 |
1008 MINNEQUA AVE |
| City | PUEBLO |
| State | CO |
| Zip Code | 81004-3733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366447922 | Gregory S Larsen | Anesthesiology | 1008 Minnequa Ave, Pueblo, CO 81004-3733 | 2005-06-20 |
| 1497360705 | Catholic Health Initiatives Colorado | Internal Medicine | 1008 Minnequa Ave, Pueblo, CO 81004-3733 | 2020-09-14 |
| 1649894833 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 1008 Minnequa Ave, Pueblo, CO 81004-3733 | 2020-06-03 |
| 1932735321 | Usacs of Colorado Inc | Emergency Medicine | 1008 Minnequa Ave, Pueblo, CO 81004-3733 | 2020-03-17 |
| 1992264105 | Heather Crump Thoreson | Pharmacist | 1008 Minnequa Ave, Pueblo, CO 81004-3733 | 2019-03-18 |
| 1225543630 | Catholic Health Iniatives Colorado | General Acute Care Hospital | 1008 Minnequa Ave, Pueblo, CO 81004-3733 | 2017-12-07 |
| 1467985713 | Richard Wayne Tsambikos | General Practice | 1008 Minnequa Ave, Pueblo, CO 81004-3733 | 2017-04-04 |
| 1053859983 | Danielle Marie Sanders | Nurse Practitioner | 1008 Minnequa Ave, Pueblo, CO 81004 | 2017-02-12 |
| 1497207336 | April Irvine | Dietitian, Registered | 1008 Minnequa Ave, Pueblo, CO 81004-3733 | 2016-10-26 |
| 1750737862 | Trevor Wilson Halle | Emergency Medicine | 1008 Minnequa Ave, Pueblo, CO 81004-3733 | 2016-05-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780155929 | Renee C Lane | Nurse Practitioner | 1925 E. Orman Ave. Ste. A109, Pueblo, CO 81004 | 2018-12-16 |
| 1215406913 | Kaiser Foundation Healthplan of Colorado | Pharmacy | 2625 W. Pueblo Blvd, Pueblo, CO 81004 | 2018-11-26 |
| 1053895532 | Rebecka Ann Reatherford | Nurse Practitioner | St Mary-corwin Medical Center, 1008 Minnequa Ave, Pueblo, CO 81004 | 2018-09-20 |
| 1124510821 | Angela M Sillas-green | Counselor | 327 Colorado Ave., Pueblo, CO 81004 | 2018-05-30 |
| 1558898569 | Alexandra R B King | Family Medicine | Southern Colorado Family Medicine, 902 Lakeview Avenue, Pueblo, CO 81004 | 2017-05-22 |
| 1578098752 | James Williams | Counselor | 414 Broadway Ave, Pueblo, CO 81004 | 2017-04-26 |
| 1740732601 | Valerie A Senger | Counselor | 635 W Corona Ave Ste 214, Pueblo, CO 81004 | 2016-10-26 |
| 1194111500 | A New Leaf Therapy, Pllc | Community/Behavioral Health | 327 Colorado Ave, Pueblo, CO 81004 | 2015-04-13 |
| 1619371671 | Mariah Mcginnis | Registered Nurse | 1232 Van Buren St., Pueblo, CO 81004 | 2014-10-20 |
| 1730593112 | Maritza Martinez | Registered Nurse | 1026 Wabriendo Ave, Pueblo, CO 81004 | 2014-06-13 |
| Find all providers in zip 81004 | ||||
| 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 |
|---|---|---|---|---|
| 1114527652 | Li Ashley Lim | Physician Assistant | 132 W B St Apt 3k, Pueblo, CO 81003-3446 | 2020-10-26 |
| 1104366178 | Alfe Garperio | Physician Assistant | 2625 W Pueblo Blvd, Pueblo, CO 81004-3816 | 2017-02-24 |
| 1871895995 | A Theodore Smith | Physician Assistant | 1600 West 24th Street, Colorado Mental Health Institute At Pueblo, Pueblo, CO 81003 | 2010-11-22 |
| 1689793812 | Paul Whitney Safford | Physician Assistant | 600 West 16th St, Pueblo, CO 81003 | 2007-03-28 |
| 1740347996 | Jose Luis Ramirez | Physician Assistant | 45825 Highway 96 East, Pueblo, CO 81006 | 2007-01-03 |
| 1932217635 | Juliana Schrettner | Physician Assistant | 1600 N Greenwood, 520, Pueblo, CO 81003 | 2006-08-25 |
| 1427046077 | James L Kramer | Physician Assistant | 1008 Minnegua Ave, Emergency Room, Pueblo, CO 81004 | 2005-10-07 |
| 1306846381 | Lucas R Derting | Physician Assistant | 1600 North Grand Avenue, Suite 500, Pueblo, CO 81003-2757 | 2005-07-29 |
| 1922001700 | Stephen D Bast | Physician Assistant | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2005-05-24 |
| 1245863257 | Anna Elizabeth Inserra | Physician Assistant | 1315 Fortino Blvd, Pueblo, CO 81008-1981 | 2020-02-18 |
| 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.