NPIMap

Individual provider Active NPI

Rebecca Clark Johnson, MD

  • Family Medicine Physician
  • Lone Tree, CO
National Provider Identifier
1073833828
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
55051 Issued in CO
Practice address
9540 Park Meadows Dr
Lone Tree, CO 80124-2894
Phone
(720) 848-9300
NPI assigned
Jun 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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 55051 CO Primary

Addresses

Primary practice location

9540 Park Meadows Dr
Lone Tree, CO 80124-2894

Mailing address

8080 Park Meadows Dr
Lone Tree, CO 80124-2557
Phone (720) 848-9330

Other practice location 1

8080 Park Meadows Dr
Lone Tree, CO 80124-2557
Phone (720) 848-9330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131217000456 TX Practitioner - Family Practice 7911150453 Reassigns benefits to 1 organization
I20160223000510 CO Practitioner - Family Practice 7911150453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Virginia School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

13123 E 16TH Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

9540 Park Meadows Dr
Lone Tree, CO 80124-2894
Phone (720) 848-9300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55051COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated CurrentSince Feb 1, 2016 Accepting new patients
University Physicians Incorporated Family Medicine CurrentSince Feb 1, 2016 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince May 13, 2014 Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

Dept 1061
Denver, CO 80256

9540 Park Meadows Dr
Lone Tree, CO 80124
Phone (720) 516-9014

8080 Park Meadows Dr
Lone Tree, CO 80124
Phone (303) 346-8828

Organizations & group practices 3

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 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1073833828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 PARK MEADOWS DR",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801242557",
            "telephone_number": "720-848-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9540 PARK MEADOWS DR",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801242894",
            "telephone_number": "720-848-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8080 Park Meadows Dr",
            "address_purpose": "LOCATION",
            "city": "Lone Tree",
            "state": "CO",
            "postal_code": "801242557",
            "country_code": "US",
            "telephone_number": "720-848-9330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "REBECCA",
        "middle_name": "CLARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "55051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lone Tree, CO

Sources for this page

Verify at the official NPI Registry.