Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jacqueline Marie Johnson, DO

Individual provider Family Medicine Physician · NPI 1083814099

Dr. Jacqueline Marie Johnson, DO is a Family Practice in Myrtle Creek, Oregon. Graduated from At Still University of Health Sciences, College of Osteo Med, Kirksville in 2006, 20 years ago. Practices with Centennial Medical Group East LLC, a 63-clinician group and accepts Medicare assignment. Licensed in Idaho and Oregon.

Years since qualifying
20
Trained at
At Still University of Health Sciences, College of Osteo Med, Kirksville
Licensed in
ID, OR
In the registry since
2007
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

145 NE Broadway St
Myrtle Creek, OR 97457-9039
Phone: (541) 677-7200
Fax: (541) 229-3309
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence DO161555 (OR)
Family Medicine Physician Taxonomy 207Q00000X · Licence O-0482 (ID)

Record details

NPI number1083814099
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 19, 2007
Last updated in NPPESAugust 9, 2023
Certification dateAugust 9, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolAT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated 2006 (20 years in practice)
Group practice Centennial Medical Group East Llc — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Myrtle Creek