NPI age
8 years
Enumerated 2018-02-26
● Active
Type 1 · Individual
Matthew Wallace Johnson, DO
Johnson is 1 of 7 emergency medicine providers in Bonners Ferry and 1 of 336 in Idaho.
Primary specialty
Emergency Medicine
Plus 2 subspecialties
Licensed in
ID, LA
2 states
Status
Active
No deactivations on record
Last NPPES update
2026-03-17
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 336 active emergency medicine providers in Idaho.
NPI age
8 years
↓ 10 yr below median (18 yr)
State licenses
2 states
Top 59% — 40% of peers are multi-state
Subspecialties
1
In the 51% of peers with subspecialties
NPI lifetime · 2018 → 2026
2018-02Enumerated in NPPES
2018
2026
Where they practice
Practice location
6640 Kaniksu St
Bonners Ferry, ID 838057532
Mailing address
6640 Kaniksu St
Bonners Ferry, ID 838057532
Additional practice locations
2 secondary locations on file with NPPES.
Location 2
25 Jacobs Gulch Rd
Kellogg, ID 838372023
Location 3
52579 Us-51
Independence, LA 70443
Specialties
-
Emergency Medicine PrimaryAn emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department....
-
Internal MedicineA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (LA) | 2524046 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 21 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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