MEDICARE: TODD E JOHNSON DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	352	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01242	OTHER	NE	BCBS - SEPN
2	01-04472	OTHER		UHC
3	01285	OTHER	NE	BCBS - LINC CARE
4	240451	OTHER	NE	MIDLAND'S CHOICE
5	07-00997	OTHER	NE	UHC
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487666814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD E JOHNSON DO

Provider Business Mailing Address
First Line	:	8055 O ST
Second Line	:	STE 300
City	:	LINCOLN
State	:	NE
Zip	:	68510-2580
Country	:	US
Telephone Number	:	402-421-0896
Fax Number	:	402-421-0945

Provider Business Practice Location Address
First Line	:	5000 N 26TH ST
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68521-4749
Country	:	US
Telephone Number	:	402-435-5300
Fax Number	:	402-435-5511

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	02/28/2008

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Directions to “ TODD E JOHNSON DO” Practice Location

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