Christopher Miles Johnson, M.D.

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

01062005A Issued in IN

Practice address

1850 Bandelier Court
Santa Fe, NM 87505-1613

Phone

(505) 795-3208

NPI assigned

Mar 21, 2006

Last updated

Apr 3, 2023By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cjohnson1350@direct.centracare.com

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.

• Centracare Clinic

  dba CentraCare - River Campus Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1043212665
  Medicare reassignment NPD
• Centracare Clinic

  dba CentraCare Occupations Health

  • Occupational Medicine Clinic/Center
  • Saint Cloud, MN
  • NPI 1366192759
  NPD
• Centracare Clinic

  dba CentraCare - Baxter Clinic

  • Multi-Specialty Clinic/Center
  • Baxter, MN
  • NPI 1679025746
  NPD
• Centracare Clinic

  dba CentraCare - St. Joseph Clinic

  • Multi-Specialty Clinic/Center
  • Saint Joseph, MN
  • NPI 1134121759
  NPD (past)
• Centracare Clinic

  dba CentraCare - Plaza Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1225030844
  NPD (past)
• Pediatrix Medical Management Group Inc

  • Neonatal-Perinatal Medicine Physician
  • Colorado Springs, CO
  • NPI 1003830282

  Pediatric Critical Care Medicine

  NPD (past)
• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1043269798
  NPD (past)

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1023077740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 BANDELIER COURT",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875051613",
            "telephone_number": "505-795-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 BANDELIER COURT",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875051613",
            "telephone_number": "505-795-3208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "MILES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CO",
            "license": "38356",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "IN",
            "license": "01062005A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200825210",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah John
• Johnson-Long Clinical Services LLC
• Amber Johnson, LPCC
• Christina Johnson
• Christopher Johnson, MA, LMHC
• Craig H Johnson, MD
• Denise Johnson
• Derek B Johnson, M.D.
• Frank Pierr Johnson, M.D.
• Gretchen T. Johnson, PT, ATC

• Pediatric Critical Care Medicine Physician in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Pediatric Critical Care Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.