DAVID A JOHNSON M.D. NPI 1922035104

NPI Information

NPI: 1922035104
Provider Name: DAVID A JOHNSON, M.D.
Classification: Surgery - 2086S0129X
Entity Type: Individual

Specialization: Vascular Surgery

Organization: ST LUKES CLINIC LLC

PECOS Registration: Yes

Address:
775 POLE LINE RD W
SUITE 213
TWIN FALLS, ID
ZIP 83301
Phone: (208) 814-8475
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David A Johnson, M.D. is a vascular surgery surgery in Twin Falls, ID with 35 years of experience. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. David A Johnson, M.D. NPI is 1922035104. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE
Graduation Year:1989

The provider's business location address is:

775 POLE LINE RD W
SUITE 213
TWIN FALLS, ID
ZIP 83301-814
Phone: (208) 814-8475
Fax: (208) 734-4177

The NPI 1922035104 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/26/2006 and was last updated on 12/29/2014.

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	2086S0129X	Surgery	Vascular Surgery	M6776	IDAHO	Yes

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	P00899554	OTHER	IDAHO	MCRR
2	003760400	MEDICAID	IDAHO
3	11329491	MEDICARE PIN	IDAHO
4	F79769	MEDICARE UPIN	IDAHO

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: 11/14/2023

NPI Synchronization or Removal

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