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BRIAN A JOHNSON MD PC NPI 1467535799


NPI Information

NPI: 1467535799
Provider Name: BRIAN A JOHNSON MD PC

Doing Business As: BRIAN A JOHNSON MD

Classification: Non-Pharmacy Dispensing Site - 332900000X
Entity Type: Organization
Address:
613 TERRACE DR
WINAMAC, IN
ZIP 46996
Phone: (574) 946-6644
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BRIAN A JOHNSON MD PC is a non pharmacy dispensing site in Winamac, IN. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) BRIAN A JOHNSON MD PC NPI is 1467535799. The provider is registered as an organization entity type.
The provider Is Doing Business As Brian A Johnson Md.

The provider's business location address is:

613 TERRACE DR
WINAMAC, IN
ZIP 46996-111
Phone: (574) 946-6644

The provider's authorized official is Direndia Shackelford .
The authorized official title is Managed Care Specialist and has the following contact phone number (800) 654-0889.

The enumeration date for this NPI number is 10/23/2006 and was last updated on 6/20/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332900000XNon-Pharmacy Dispensing Site5003424AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11535561OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2100210710MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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