Cooper Johnston, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

007402 Issued in AZ

Practice address

4122 N 17TH St
Phoenix, AZ 85016-5922

Phone

(928) 543-1515

NPI assigned

May 22, 2015

Reactivated

Jul 8, 2020

Last updated

May 21, 2024By 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

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Family Practice

Education

Arizona College of Osteopathic Medicine Mid Western University, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

RHG of Arizona PCGroup PAC ID 9436689445, 18 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cooper.johnston.1@32866.direct.athenahealth.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.

• RHG of Arizona, PC

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1013744218
  Medicare reassignment Care Compare group NPD
• Heritage Technologies, LLC

  dba Desert Grove Family Medical

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1093764938
  Medicare reassignment NPD
• CMJ Recovery Az LLC

  • Psychiatric Hospital
  • Phoenix, AZ
  • NPI 1558988246
  NPD (past)
• Royal Az LLC

  dba Royal Life Centers

  • Psychiatric Hospital
  • Prescott, AZ
  • NPI 1013668219
  NPD (past)

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

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1073992087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22744 E MAYA RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851422834",
            "telephone_number": "480-678-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 N 17TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165922",
            "telephone_number": "928-543-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "COOPER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-22",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "deactivation_date": "2020-06-17",
        "reactivation_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "007402",
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "AZ",
            "license": "007402",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zvinashe Johnson, RN
• Alicia Johnston
• Christine Lynn Johnston, PSY.D.
• Clarissa Johnston, DO
• Codi Vonnice Johnston, MSN, APRN, FNP-C
• Curtis A Johnston, M.D.
• Eleanor Johnston, MD
• Gregory Scott Johnston, M.D.
• Janice G Johnston, M.D.
• Jeffrey S. Johnston, M.D.

• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.

Verify at the official NPI Registry.