RUSSELL A JOHANSON (NPI# 1902190051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902190051 |
| Entity Type | Individual |
| Full Name | RUSSELL A JOHANSON |
| Credential | M.D. |
| Practice Address |
2500 S Woodworth Loop Palmer AK 99645-8984 |
| Mailing Address |
Po Box 718 Palmer AK 99645-0718 |
| Practice Telephone | 9078616000 |
| Practice Fax Number | 9078616000 |
| Mailing Telephone | 9077467511 |
| Mailing Fax Number | 9077467533 |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2017-11-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | MEDS7975 | AK | Allopathic & Osteopathic Physicians |
| Street Address |
2500 S WOODWORTH LOOP |
| City | PALMER |
| State | AK |
| Zip Code | 99645-8984 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629067590 | Roy Fukuoka | Nurse Anesthetist, Certified Registered | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2005-10-13 |
| 1720603939 | Robert A Grogan | Pharmacist | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2020-06-12 |
| 1184258170 | Michelle Hailey Allen | Registered Nurse | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2020-02-27 |
| 1528615424 | Tara E Bonardi | Nurse Anesthetist, Certified Registered | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2019-08-25 |
| 1619532215 | Eric Atkinson | Registered Nurse | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2019-05-08 |
| 1588133748 | Erin Alaina Reding | Nurse Practitioner | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2018-11-17 |
| 1043722929 | Fireweed Surgical Assists LLC | Nurse Practitioner | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2017-10-31 |
| 1740713866 | Annette Kasprzak | Emergency Medicine | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2017-04-05 |
| 1669858106 | Jesse Atwood Md Pediatrics, LLC | Pediatrics | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2015-08-06 |
| 1881080018 | Kili Grace O'bryant | Emergency Medicine | 2500 S Woodworth Loop, Palmer, AK 99645 | 2015-04-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295357135 | Kasey M Flintoft | Occupational Therapist | 7200 E. Jim Cottrell Cir, Palmer, AK 99645 | 2020-05-14 |
| 1629601471 | Courtney Randol | Licensed Practical Nurse | 14405 E Pace Dr., Palmer, AK 99645 | 2020-02-20 |
| 1689213092 | Valerie Anne Delaune | Acupuncturist | 9693 N. Little Otter Dr., Palmer, AK 99645 | 2020-01-02 |
| 1003464512 | Alaskan Sunrise Behavioral Health, L.L.C. | Clinic/Center | 14460 E. Pace Dr., Palmer, AK 99645 | 2019-08-28 |
| 1548814718 | Maple Springs of Palmer Snf Holdings, LLC | Skilled Nursing Facility | 12130 E Maple Springs Way, Palmer, AK 99645 | 2019-07-26 |
| 1952868655 | Carla Beth Kelly | Physical Therapist | 7200 Jim Cottrell Circle, Palmer, AK 99645 | 2019-02-28 |
| 1366938375 | Wendy S Page | Behavior Technician | 7200 E Jim Cottrell, Wasilla, AK 99645 | 2018-07-03 |
| 1154845170 | Sarah Elizabeth Gilliland | Occupational Therapist | 7200 E Jim Cottrell Circle, Palmer, AK 99645 | 2017-08-01 |
| 1558885137 | Garland Brooks | Massage Therapist | 1934 Prospect Dr, Palmer, AK 99645 | 2017-07-26 |
| 1386165009 | Sommer Dawn Nielsen | Massage Therapist | 3566 N Mars Ave., Palmer, AK 99645 | 2017-07-03 |
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| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760532006 | Robert D Hagberg | Emergency Medicine | Mat Su Empercency Medicine Physicians At Msrmc, 2500 S. Woodworth Loop, Palmer, AK 99645 | 2007-01-11 |
| 1811984867 | Janet L Smalley | Emergency Medicine | 16750 E Huntley Rd, Palmer, AK 99645-8718 | 2005-10-04 |
| 1740713866 | Annette Kasprzak | Emergency Medicine | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2017-04-05 |
| 1093247918 | Zachary C. Demma | Emergency Medicine | 40 Wright St, Palmer, MA 01069-1138 | 2017-03-30 |
| 1275995433 | Jonathan A Chinea | Emergency Medicine | 40 Wright Street, Palmer, MA 01069-1138 | 2016-03-25 |
| 1881080018 | Kili Grace O'bryant | Emergency Medicine | 2500 S Woodworth Loop, Palmer, AK 99645 | 2015-04-14 |
| 1629365267 | Joseph Moss Alter | Emergency Medicine | 2500 S Woodworth Loop, Palmer, AK 99645 | 2011-07-04 |
| 1982990990 | Ryan A Biornstad | Emergency Medicine | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2011-06-28 |
| 1437382678 | John Elliott Reynolds | Emergency Medicine | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2009-09-03 |
| 1114151073 | Thomas W Quimby | Emergency Medicine | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2009-05-07 |
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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.