MEDICARE: DR. CHRISTOPHER D JOHNSON MD

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	207X00000X	Orthopaedic Surgery Physician	MA45468	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	200026579	OTHER	NJ	RR MEDICARE
4	CC3884	OTHER	NJ	RR MEDICARE GRP#

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	88635	OTHER	NJ	AETNA
5	J28288	OTHER	NJ	HEALTHNET
6	917485	OTHER	NJ	PHS/GUARDIAN
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	P2042087	OTHER	NJ	OXFORD
9	361165800	OTHER	NJ	US DEPT OF LABOR
10	1196841	OTHER	NJ	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1841277993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER D JOHNSON MD

Provider Business Mailing Address
First Line	:	776 SHREWSBURY AVE
Second Line	:	SUITE 201
City	:	TINTON FALLS
State	:	NJ
Zip	:	07724-3006
Country	:	US
Telephone Number	:	732-530-4949
Fax Number	:	732-212-1171

Provider Business Practice Location Address
First Line	:	776 SHREWSBURY AVE
Second Line	:	SUITE 201
City	:	TINTON FALLS
State	:	NJ
Zip	:	07724-3006
Country	:	US
Telephone Number	:	732-530-4949
Fax Number	:	732-530-3618

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

Provider Enumeration Date	:	12/29/2005
Last Update Date	:	03/13/2013

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