ELIZABETH RAE JOHNSON (NPI# 1972538650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972538650 |
| Entity Type | Individual |
| Full Name | ELIZABETH RAE JOHNSON |
| Other Name | ELIZABETH BROMMENSCHENKEL |
| Credential | P.A. |
| Practice Address |
506 1st Ave Se Watertown SD 57201-4402 |
| Practice Telephone | (605) 886-8482 |
| Practice Fax Number | 6058844332 |
| Mailing Telephone | 6058868482 |
| Mailing Fax Number | 6058844300 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2019-11-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1098 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1901 Connecticut Ave. S, Sartell, MN 56377 | 3202594100 | 3202598044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374843 | Elizabeth Ann Johnson | Psychologist | 3640 Stanton St Apt 107, Philadelphia, PA 19129-1683 | 2020-10-20 |
| 1275169138 | Elizabeth Layla Johnson | Social Worker | 978 Dekalb Ave Apt 3, Brooklyn, NY 11221-6404 | 2020-03-22 |
| 1477032746 | Elizabeth Lee Johnson | Nurse Practitioner | 11239 Gallia Pike Rd, Wheelersburg, OH 45694 | 2018-08-08 |
| 1174013957 | Elizabeth Johnson | Psychologist | 322 5th Ave Apt A, San Francisco, CA 94118-2310 | 2018-05-16 |
| 1245739937 | Elizabeth Anne Johnson | Specialist/Technologist | 900 Nw Bryant St, Pullman, WA 99163-3009 | 2018-02-08 |
| 1720591886 | Elizabeth Michele Johnson | Licensed Practical Nurse | 16 Dartmouth Rd, Highland Mills, NY 10930-2605 | 2017-11-13 |
| 1417466046 | Elizabeth A Johnson | Nurse Practitioner | 1107b Brookdale St, Martinsville, VA 24112-4501 | 2017-09-27 |
| 1619495934 | Elizabeth Johnson | Speech-Language Pathologist | 103 Briarbrook Dr, East Peoria, IL 61611-4474 | 2017-09-07 |
| 1053834572 | Elizabeth Kaye Johnson | Social Worker | 3060 Royal Blvd S Ste 210, Alpharetta, GA 30022-1443 | 2017-07-18 |
| 1699162503 | Elizabeth Johnson | Occupational Therapist | E6717 County Road Nn, Viroqua, WI 54665-7724 | 2015-04-17 |
| Street Address |
506 1ST AVE SE |
| City | WATERTOWN |
| State | SD |
| Zip Code | 57201-4402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275522732 | Brown Pharmacy LLC | Pharmacy | 506 1st Ave Se, Watertown, SD 57201-4402 | 2005-10-18 |
| 1831709369 | Heidi Maurine Barber | Nurse Practitioner | 506 1st Ave Se, Watertown, SD 57201-4499 | 2020-08-10 |
| 1497363113 | Allison Judeen Decurtins | Nurse Practitioner | 506 1st Ave Se, Watertown, SD 57201-4499 | 2020-07-20 |
| 1457903833 | Abby Lynne Simon | Physician Assistant | 506 1st Ave Se, Watertown, SD 57201-4499 | 2019-07-15 |
| 1699327262 | Rachel Leiseth | Physician Assistant | 506 1st Ave Se, Watertown, SD 57201-4499 | 2019-07-12 |
| 1336617604 | Jennifer Guest | Health Educator | 506 1st Ave Se, Watertown, SD 57201-4499 | 2018-11-05 |
| 1184192650 | Kristina R Boetel | Nurse Practitioner | 506 1st Ave Se, Watertown, SD 57201-4499 | 2018-11-02 |
| 1942775713 | Rebekah Ruth Storm | Nurse Practitioner | 506 1st Ave Se, Watertown, SD 57201-4499 | 2018-10-09 |
| 1205225661 | Abby M Gietzen | Physician Assistant | 506 1st Ave Se, Watertown, SD 57201-4402 | 2015-01-22 |
| 1205230414 | Eric L. Woolley | Podiatrist | 506 1st Ave Se, Watertown, SD 57201 | 2014-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245878032 | Samantha Kay Kratovil | Dietitian, Registered | 4 19th St Ne, Watertown, SD 57201 | 2019-12-12 |
| 1326516501 | Edgewood Watertown Mc 2 LLC | Assisted Living Facility | 225 14 Ave Ne, Watertown, SD 57201 | 2018-11-06 |
| 1023503406 | Rhonda Jean Cyre | Occupational Therapy Assistant | 613 B 1st Ave Se, Watertown, SD 57201 | 2018-06-27 |
| 1083160717 | Joyce Anderson | Psychologist | 1124 Konrady Dr. Ne, Watertown, SD 57201 | 2016-09-01 |
| 1336584630 | Jeffrey Alan Dorrity | Otolaryngology | 1201 Mickelson Dr, Watertown, SD 57201 | 2013-05-01 |
| 1427397389 | Vickie Lynn Burchatz | Occupational Therapy Assistant | 415 Fourth Avenue Ne, Golden Living Center, Watertown, SD 57201 | 2013-02-12 |
| 1215292560 | Eagle Vision | Eyewear Supplier (Equipment, not the service) | 906 1/2 9th Ave Se, Watertown, SD 57201 | 2012-07-11 |
| 1669777462 | Eve Lynn Hensler | Audiologist | 405 18th Ave. Ne, Professional Hearing Services, Inc., Watertown, SD 57201 | 2011-01-26 |
| 1760792261 | Maria Redmond | Physical Therapist | 810 South Maple, Watertown, SD 57201 | 2010-10-18 |
| 1194918995 | Colette Wheeler | Occupational Therapist | 17330, 458th Ave, Watertown, SD 57201 | 2007-08-24 |
| Find all providers in zip 57201 | ||||
| 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 |
|---|---|---|---|---|
| 1457961765 | Samantha Jewers | Physician Assistant | 20 California Park, Watertown, MA 02472-2517 | 2020-08-03 |
| 1134757743 | Hira Bakshi | Physician Assistant | 295 Barben Ave, Watertown, NY 13601-4501 | 2020-03-30 |
| 1538795661 | Stephen Robinson | Physician Assistant | 26076 Liberty Ave, Watertown, NY 13601-5910 | 2020-03-20 |
| 1730695941 | Razi Odean Mirshahi | Physician Assistant | 183 Mount Auburn St Apt 46, Watertown, MA 02472-4012 | 2017-12-26 |
| 1790111797 | Marisa Hamlin | Physician Assistant | 22670 Summit Dr Bldg 6, Watertown, NY 13601-7208 | 2013-09-23 |
| 1639476260 | Kell T Giffin | Physician Assistant | 930 Holcomb St, Watertown, NY 13601-4228 | 2011-02-17 |
| 1306068812 | Mountain Medical of Watertown | Physician Assistant | 457 Gaffney Dr, Watertown, NY 13601 | 2007-05-03 |
| 1073677498 | Nonna Khachiyan | Physician Assistant | 11 Mason Rd, Watertown, MA 02472-3314 | 2006-12-20 |
| 1528167277 | Mark Andrew Knowles | Physician Assistant | 457 Gaffney Drive, Watertown, NY 13601-1834 | 2006-09-21 |
| 1336167709 | Michelle Lynne Boulton | Physician Assistant | 171 E. Hoard Street, Watertown, NY 13601-1515 | 2006-07-17 |
| Find all providers in WATERTOWN | ||||
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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.