Brett M Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1081 Issued in SD

Practice address

61 Charles St
Deadwood, SD 57732-1303

Phone

(605) 717-6000

NPI assigned

May 25, 2017

Last updated

May 25, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rapid City Indian Health Service Hospital

  • General Acute Care Hospital
  • Rapid City, SD
  • NPI 1316900327
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495670400000",
    "number": "1003344789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 CHARLES ST",
            "city": "DEADWOOD",
            "state": "SD",
            "postal_code": "577321303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 CHARLES ST",
            "city": "DEADWOOD",
            "state": "SD",
            "postal_code": "577321303",
            "telephone_number": "605-717-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRETT",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-25",
        "last_updated": "2017-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "1081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James T Holloway, MD
• Lennard Hopper, D.D.S.
• Peggy L Hubbard, PA-C
• Kay K Huhnerkoch, PA
• Ashley Johnson, PHARMD
• Keri Lee Johnson, LMT
• Donald Howard Kelley, M.D.
• Terry Lloyd Keszler, CRNA
• Jenna Lampe
• Mandi Marie Leite, PMHNP-BC

• Physician Assistant in Deadwood, SD
• Providers in Deadwood, SD by specialty
• Physician Assistant in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.