Bradley S Johnson, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

8950 Issued in TN

Practice address

1551 E Morris Blvd
Morristown, TN 37813-5729

Phone

(423) 587-8383

Fax

(423) 587-8382

NPI assigned

Apr 13, 2009

Last updated

Dec 21, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1023251642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 E MORRIS BLVD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378135729",
            "telephone_number": "423-587-8383",
            "fax_number": "423-587-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 E MORRIS BLVD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378135729",
            "telephone_number": "423-587-8383",
            "fax_number": "423-587-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRADLEY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-13",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "8950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151-3459",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randall Stetson Jenkins, DDS
• Taryn Jinnette, DO
• JJ Beans at Howards LLC
• JJ Beans LLC (College Park Pharmacy)
• JJ Beans LLC (College Park Pharmacy)
• David A Johnson, MD
• Kevin Brandt Johnson, DO
• Linda Arlene Johnson, CPED/CFO
• Ashton Lee Johnston
• Krista Jolynn Johnston, MSSW

• Oral and Maxillofacial Surgery (Dentist) in Morristown, TN
• Providers in Morristown, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.