Active NPI
Michael Wynn Johnson, MD
- Orthopaedic Surgery Physician
- Sandy, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 6782459-1205
- Practice address
- 9450 S 1300 E
Ste 120
Sandy, UT 84094-5555 - Phone
- (801) 501-5500
- Fax
- (801) 501-5800
- NPI assigned
- Mar 15, 2006
- Last updated
- Jun 9, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MD23859 | OR | |
| Orthopaedic Surgery Physician | 207X00000X | 6782459-1205 | UT | Primary |
Addresses
Primary practice location
9450 S 1300 E
Ste 120
Sandy, UT 84094-5555
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 501-5500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073582862 | Medicaid | UT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- University of Utah School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9450 S 1300
Suite 210
Sandy, UT 84094-5559
Phone (801) 501-6500
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hip replacement | 67 |
| Knee replacement | 77 |
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD23859 | OR | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Past | Accepting new patients | |
| Patrick L Hanley MD PC | Orthopaedic Surgery | Past | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
9450 S 1300 E
Ste 120
Sandy, UT 84094
Phone (801) 501-2113
9450 S 1300 E
Ste 210
Sandy, UT 84094
Phone (801) 501-4305
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Sandy, UT
- NPI 1942325154
-
dba Snowbird Clinic
- Emergency Medicine Physician
- Snowbird, UT
- NPI 1275815565
-
dba St George Adolescent Partial Hospitalization
- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
dba Orem Community Hospital Physicians
- Multi-Specialty Clinic/Center
- Orem, UT
- NPI 1588601124
-
dba Pacific Orthopaedics & Sports Medicine
- Orthopaedic Surgery Physician
- Portland, OR
- NPI 1861551616
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Intermountain Health Home Health Heber City
- Home Health Agency
- South Jordan, UT
- NPI 1447344098
-
dba Intermountain Health Alta View Hospital
- General Acute Care Hospital
- Sandy, UT
- NPI 1962412486
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307577600000",
"number": "1073582862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128",
"telephone_number": "801-501-5500",
"fax_number": "801-501-5800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9450 S 1300 E",
"address_2": "STE 120",
"city": "SANDY",
"state": "UT",
"postal_code": "840945555",
"telephone_number": "801-501-5500",
"fax_number": "801-501-5800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MICHAEL",
"middle_name": "WYNN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-15",
"last_updated": "2011-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "OR",
"license": "MD23859",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "UT",
"license": "6782459-1205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1073582862",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sandy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.