NPIMap

Individual provider Active NPI

Paul Michael Johnson, M.D.

  • Family Medicine Physician
  • Moab, UT
National Provider Identifier
1063826832
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9548764-1205 Issued in UT
Practice address
450 Williams Way
Moab, UT 84532-2185
Phone
(435) 719-3500
NPI assigned
Jun 19, 2014
Last updated
Sep 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9548764-1205 UT Primary

Addresses

Primary practice location

450 Williams Way
Moab, UT 84532-2185

Mailing address

450 Williams Way
Moab, UT 84532-2185
Phone (435) 719-3500

Other practice location 1

1250 E 3900 S
Suite 260
Salt Lake City, UT 84124-1348
Phone (801) 265-2000 ext. 120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171013000879 UT Practitioner - Family Practice 1658681895 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Utah School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moab Valley Healthcare, Inc.Group PAC ID 2466361720, 18 clinicians

Practice addresses (Care Compare)

450 Williams Way
Moab, UT 84532-2185
Phone (435) 719-3500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9548764-1205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moab Valley Healthcare, Inc. CurrentSince Oct 8, 2025 Accepting new patients
County of Ventura Current Accepting new patients
Utah Healthcare Institute Inc Family Medicine PastSince Jul 1, 2000 Accepting new patients

Locations

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

800 S Victoria Ave
#L4640
Ventura, CA 93009

450 W Williams Way
Moab, UT 84532
Phone (435) 259-7191

476 W Williams Way
Moab, UT 84532
Phone (435) 719-3500

Interoperability endpoints

  • Direct secure messaging: pabloj@mrhmoab.securechart.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1063826832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 WILLIAMS WAY",
            "city": "MOAB",
            "state": "UT",
            "postal_code": "845322185",
            "telephone_number": "435-719-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WILLIAMS WAY",
            "city": "MOAB",
            "state": "UT",
            "postal_code": "845322185",
            "telephone_number": "435-719-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E 3900 S",
            "address_2": "Suite 260",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841241348",
            "country_code": "US",
            "telephone_number": "801-265-2000 x120",
            "fax_number": "801-265-2008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-19",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "9548764-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moab, UT

Sources for this page

Verify at the official NPI Registry.