RUSSELL P JOHNSON PA-C NPI 1497712483

NPI Information

NPI: 1497712483
Provider Name: RUSSELL P JOHNSON, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
7021 SPRING MOUNTAIN RD
LAS VEGAS, NV
ZIP 89117
Phone: (702) 803-2222
Get Directions

Russell P Johnson, PA-C is a medical physician assistant in Las Vegas, NV. Russell P Johnson, PA-C NPI is 1497712483. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7021 SPRING MOUNTAIN RD
LAS VEGAS, NV
ZIP 89117-818
Phone: (702) 803-2222
Fax: (702) 829-7269

The NPI 1497712483 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 4/26/2006 and was last updated on 11/27/2020.

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
1	208VP0000X	Pain Medicine	Pain Medicine	MA003569L	PENNSYLVANIA	No
2	363AM0700X	Physician Assistant	Medical	PA1753	NEVADA	Yes
3	363AM0700X	Physician Assistant	Medical	MA003569L	PENNSYLVANIA	No

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
1	1336749811	OTHER	NEVADA	GROUP NPI
2	1497712483	MEDICAID	NEVADA

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: 4/28/2024

NPI Synchronization or Removal

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