Newly enumerated
The official enumeration date falls within the documented new-enumeration window.
- Enumeration date is 25 days before observation
Type 1 individualNPI 1063338333
JACOB T JOHNSON
1835P1400X · FORT PIERRE, SD
Why this profile is appearing now
Observed change signals
Reported classification
Taxonomies
| Code | Description | Source flag |
|---|---|---|
| 1835P1400X | 1835P1400X | Primary |
| 1835P1400X | 1835P1400X | Additional |
| 1835P1400X | 1835P1400X | Additional |
| 1835P1400X | 1835P1400X | Additional |
| 1835P1400X | 1835P1400X | Additional |
Taxonomy reporting does not establish licensure, board certification, expertise, or quality.
Longitudinal record
Observed change timeline
- 0 recorded field change s