Individual
RUSSELL P JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
MA003569L
PA
363AM0700X
Medical Physician Assistant
MA003569L
PA
363AM0700X
Medical Physician Assistant
Primary
PA1753
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336749811
GROUP NPI
NV
05
—
1497712483
—
NV
Enumeration date
04/26/2006
Last updated
11/27/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up