| Brett C Johnson, DO | |
|
101 Bodin Cir, Travis Afb, CA 94535-1809 | |
| (707) 423-3383 | |
| Not Available |
| Full Name | Brett C Johnson |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 15 Years |
| Location | 101 Bodin Cir, Travis Afb, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023337185 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | O-0729 (Idaho) | Primary |
| 207P00000X | Emergency Medicine | 20A13693 (California) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Signature Healthcare At Home | Nampa, ID | Home health agency |
| Saint Alphonsus Home Health & Hospice | Boise, ID | Hospice |
| Encompass Home Health & Hospice Of Idaho | Nampa, ID | Hospice |
| Signature Hospice | Payette, ID | Hospice |
| St Luke's Regional Medical Center | Boise, ID | Hospital |
| Saint Alphonsus Medical Center - Ontario, Inc | Ontario, OR | Hospital |
| St Luke's Nampa Medical Center | Nampa, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Lukes Clinic-treasure Valley Llc | 4981878402 | 1062 |
| St Lukes Clinic-treasure Valley Llc | 4981878402 | 1062 |
| Entity Name | St Lukes Clinic-treasure Valley Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 |
| Mailing Address | Practice Location Address |
|---|---|
| Brett C Johnson, DO 101 Bodin Cir, Travis Afb, CA 94535-1809 Ph: (707) 423-3383 | Brett C Johnson, DO 101 Bodin Cir, Travis Afb, CA 94535-1809 Ph: (707) 423-3383 |
Dr. Patrick Aaron Shea, M.D. Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-3369 | |
Dr. Breanna L Gawrys, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-3057 | |
Courtney Ann Dawley, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-3000 Fax: 707-423-3501 | |
Dr. Brian M Davis, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-7113 | |
Dr. David M Olson, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 101 Bodin Circle, Travis Afb, CA 94535 Phone: 707-423-3842 | |
Dr. Kristen Elizabeth Taleck, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-7622 |