MR. BRIAN ROBERT JOHNSON (NPI# 1962895888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962895888 |
| Entity Type | Individual |
| Full Name | MR. BRIAN ROBERT JOHNSON |
| Credential | N.P. |
| Practice Address |
1350 Parkway Dr Blackfoot ID 83221-1657 |
| Mailing Address |
98 Poplar St Blackfoot ID 83221-1758 |
| Practice Telephone | 2087822415 |
| Practice Fax Number | 2087822411 |
| Mailing Telephone | 2087854100 |
| Mailing Fax Number | 2087858529 |
| Enumeration Date | 2015-03-17 |
| Last Update Date | 2016-05-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
NP-1550A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649871617 | Brian Anders Johnson | Student in an Organized Health Care Education/Training Program | 720 S River Rd Ste B105, St George, UT 84790-5704 | 2020-11-05 |
| 1669002630 | Brian A Johnson | Counselor | 16978 W Santiago Cir, Hauser, ID 83854-8153 | 2020-01-18 |
| 1770063687 | Brian Johnson | Optometrist | 1200 W Godfrey Avenue, Philadelphia, PA 19141-3323 | 2018-08-20 |
| 1467979013 | Brian R Johnson Jr. | Massage Therapist | 275 Sw 160th St Ste 201, Burien, WA 98166-3003 | 2017-08-24 |
| 1851817316 | Brian Johnson | Driver | 2919 Providence Creek Rd, North Chesterfield, VA 23236-5267 | 2017-08-16 |
| 1033630330 | Brian Bradley Johnson | Pediatrics | Children's Hospital Outpatient Center, 14 Medical Park, Ste 400, Columbia, SC 29203 | 2017-06-28 |
| 1356870158 | Brian Johnson | Private Vehicle | 52 Saint Pauls Rd, Warsaw, VA 22572-4436 | 2017-06-06 |
| 1538601554 | Brian David Johnson | Occupational Therapist | 7370 Cabot Ct Ste 101, Melbourne, FL 32940-8263 | 2016-11-08 |
| 1548630122 | Brian Johnson | Technician, Cardiology | 1163 Bridge Mill Ave, Canton, GA 30114-7713 | 2015-09-25 |
| 1093111817 | Brian Johnson | Home Health | 9446 Crockett Pass, Hamilton, OH 45011-9054 | 2014-11-05 |
| Street Address |
1350 PARKWAY DR |
| City | BLACKFOOT |
| State | ID |
| Zip Code | 83221-1657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902853096 | Valley Medical Shoppe Inc | Durable Medical Equipment & Medical Supplies | 1350 Parkway Dr, Ste 26, Blackfoot, ID 83221-1657 | 2006-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932711165 | Samantha Paige Averett | Social Worker | 60 N Broadway, Blackfoot, ID 83221 | 2020-08-19 |
| 1730711656 | Sara Marie Letham | Family Medicine | 33 S Thompson Lane, Blackfoot, ID 83221 | 2020-02-08 |
| 1962994962 | Tyler Thomas Wood | Student in an Organized Health Care Education/Training Program | 98 Poplar Street, Blackfoot, Id 83221, Blackfoot, ID 83221 | 2018-06-05 |
| 1801336276 | Bmh, Inc. | Internal Medicine | 235 Poplar St, Blackfoot, ID 83221 | 2017-03-03 |
| 1497119804 | Susan Doran | Social Worker | 720 E. Alice, Blackfoot, ID 83221 | 2016-04-12 |
| 1427412121 | Josie Russell Adkins | Counselor | 720 East Alice, Blackfoot, ID 83221 | 2016-04-08 |
| 1740590314 | Ashley Nichole Thomas | Physician Assistant | 710 E. Alice Street, Blackfoot, ID 83221 | 2010-10-18 |
| 1528373313 | Stephanie Lynn Henderson | Dietitian, Registered | 1555 Vernon Ave, Blackfoot, ID 83221 | 2010-08-17 |
| 1184850141 | Joy H. Taylor | Nurse Practitioner | 1441 Parkway Drive, Blackfoot, ID 83221 | 2009-06-04 |
| 1427232925 | Nathan E. Sneddon | Anesthesiology | 98 Poplar St Fl 3, Blackfoot, ID 83221 | 2007-12-20 |
| Find all providers in zip 83221 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427415835 | Brittany Marie Czerna | Nurse Practitioner | 1791 Frontage Rd, Blackfoot, ID 83221-6324 | 2016-01-15 |
| 1174581425 | Kay M Powell | Nurse Practitioner | 9 Airport Rd, Blackfoot, ID 83221-1702 | 2006-05-03 |
| 1033674916 | Advanced Integrated Medical Center | Nurse Practitioner | 1395 Nw Main St, Blackfoot, ID 83221-3936 | 2019-02-05 |
| 1295223493 | Carolyn Louise Hansen | Nurse Practitioner | 98 Poplar St, Blackfoot, ID 83221-1799 | 2018-04-24 |
| 1720580848 | Shandra Dee Averett | Nurse Practitioner | 98 Poplar St, Blackfoot, ID 83221-1758 | 2018-03-05 |
| 1720448590 | Max Barney | Nurse Practitioner | 1441 Parkway Dr, Blackfoot, ID 83221-1667 | 2016-03-07 |
| 1477984524 | Shantel Steffler | Nurse Practitioner | 1441 Parkway Dr, Blackfoot, ID 83221-1667 | 2013-11-27 |
| 1821253683 | Jonathan Keith Williams | Nurse Practitioner | 1441 Parkway Dr, Blackfoot, ID 83221-1667 | 2008-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427152 | Christopher Alan Anthony Nicholas | Nurse Practitioner | 2889 N Chancery Pl, Meridian, ID 83646-7407 | 2020-11-05 |
| 1710588108 | Lauren Proteau | Nurse Practitioner | 310 S Acer Loop, Post Falls, ID 83854-8809 | 2020-11-03 |
| 1568061398 | Nicolette A Eberline | Nurse Practitioner | 4228 W Guard St Bldg 665, Boise, ID 83705-8049 | 2020-10-22 |
| 1023617347 | Kristina Oliver | Nurse Practitioner | 980 W Ironwood Dr Ste 302, Coeur D Alene, ID 83814-2668 | 2020-10-19 |
| 1730787482 | John Dustin Pena | Nurse Practitioner | 102 Courthouse Dr Ste F, Salmon, ID 83467-3905 | 2020-10-14 |
| 1982202743 | Jayson Paul Smith | Nurse Practitioner | 1545 East Leighfield Dr., Meridian, ID 83646 | 2020-10-14 |
| 1659979516 | Jennifer Anne Gardner | Nurse Practitioner | 1385 Park View Dr Ste 101, Twin Falls, ID 83301-4390 | 2020-10-13 |
| 1982210795 | Samuel Hally | Nurse Practitioner | 1346 Cimarron Ct, Middleton, ID 83644-5894 | 2020-09-17 |
| 1013522275 | Beau Lee | Nurse Practitioner | 2900 N Burton St, Boise, ID 83704-5314 | 2020-09-14 |
| 1649885534 | Auston Whitmer | Nurse Practitioner | 2203 E Ringneck St, Meridian, ID 83646-7410 | 2020-09-09 |
| 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.