Individual provider Active NPI

Wendell C Johnson, M.D.

  • Body Imaging Physician
  • Murray, UT
National Provider Identifier
1083654065
Registry record updated Nov 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
License
276179-1205 Issued in UT
Practice address
5444 S. Green St.
Murray, UT 84123-5632
Phone
(801) 262-2647
Fax
(801) 262-3897
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X M-10293 ID
Body Imaging Physician 2085B0100X 276179-1205 UT Primary
Diagnostic Radiology Physician 2085R0202X 276179-1205 UT

Addresses

Primary practice location

5444 S. Green St.
Murray, UT 84123-5632

Mailing address

5444 S. Green St.
Murray, UT 84123-5632
Phone (801) 262-8120

Other identifiers 1

IdentifierTypeStateIssuer
D3403MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID, WA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20040209000650 UT Practitioner - Diagnostic Radiology 7416841887 Reassigns benefits to 3 organizations
I20080711000189 ID Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 7416841887 Reassigns benefits to 1 organization
I20260225002921 WA Practitioner - Diagnostic Radiology 7416841887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Utah School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1380 E Medical Ctr Dr
St George, UT 84790-2123
Phone (435) 251-1000

5121 S Cottonwood St
Murray, UT 84107-5701

8 TH Ave and C St
LDS Hosp Eeg Phys GRP
Salt Lake City, UT 84143
Phone (801) 507-7000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tellica Imaging, LLC CurrentSince Feb 21, 2022 Accepting new patients
Tellica Imaging, LLC CurrentSince Apr 13, 2023 Accepting new patients
Mountain Medical Physician Specialists PC Body Imaging CurrentSince May 1, 2002 Accepting new patients
Tellica Imaging - Washington LLC Diagnostic Radiology CurrentSince Jan 12, 2026 Accepting new patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
Ihc Health Services Inc CurrentSince Jan 1, 2017 Accepting new patients
Tellica Imaging - Washington LLC Diagnostic Radiology CurrentSince Jan 12, 2026 Accepting new patients
Tellica Imaging, LLC CurrentSince Nov 16, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Tellica Imaging, LLC CurrentSince Feb 21, 2022 Accepting new patients
Tellica Imaging, LLC Diagnostic Radiology CurrentSince Nov 16, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 12, 2024 Accepting new patients
Ihc Health Services Inc Past Accepting new patients
University Radiology Associates Body Imaging PastSince Feb 1, 1997 Accepting new patients

Locations

8505 W Overland Rd
Boise, ID 83709
Phone (208) 417-5100

1501 Hiland Ave
Burley, ID 83318
Phone (208) 678-4444

1887 Whitney Mesa Dr
Henderson, NV 89014
Phone (702) 819-0368

5444 S Green St
Salt Lake City, UT 84123
Phone (801) 262-2647

5295 S Commerce Dr
Ste 550
Salt Lake City, UT 84107
Phone (801) 313-4110

5217 S State St
Salt Lake City, UT 84107
Phone (801) 313-4110

5217 S State St
Ste 200
Salt Lake City, UT 84107
Phone (208) 417-5100

5323 S Woodrow St
Salt Lake City, UT 84107
Phone (801) 261-8346

296 E 3900 S
Salt Lake Cty, UT 84107
Phone (801) 262-8120

36 S Street St
Ste 2200
Salt Lake Cty, UT 84111
Phone (385) 622-0669

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

1486 E Skyline Dr
South Ogden, UT 84405
Phone (801) 475-4552

4401 Harrison Blvd
South Ogden, UT 84403
Phone (801) 387-2800

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

3930 W Parkway Blvd
West Valley City, UT 84120
Phone (435) 462-2441

421 E Main St
Auburn, WA 98002
Phone (253) 204-2530

2941 S 38th St
Ste E
Tacoma, WA 98409
Phone (253) 534-8689

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

Hospital & facility affiliations 5

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1083654065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5444 S. GREEN ST.",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841235632",
            "telephone_number": "801-262-8120",
            "fax_number": "801-262-5721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5444 S. GREEN ST.",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841235632",
            "telephone_number": "801-262-2647",
            "fax_number": "801-262-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "WENDELL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-10293",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "UT",
            "license": "276179-1205",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "276179-1205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D3403",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.