Individual provider Active NPI

Brad Robert Johnston, CRNA

  • Certified Registered Nurse Anesthetist
  • Panama City, FL
National Provider Identifier
1104004894
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ANT3177982 Issued in FL
Practice address
801 E 6TH St
Suite 205
Panama City, FL 32401-3661
Phone
(850) 785-3185
Fax
(850) 785-6233
NPI assigned
Feb 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ANT3177982 FL Primary

Addresses

Primary practice location

801 E 6TH St
Suite 205
Panama City, FL 32401-3661

Mailing address

801 E 6TH St
Suite 205
Panama City, FL 32401-3661
Phone (850) 785-3185

Other identifiers 2

IdentifierTypeStateIssuer
G4459OtherFLBCBS
ANT3177982OtherFLLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200707000588 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 0244318368 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Anesthesia Services PLLCGroup PAC ID 3971850892, 49 clinicians
Ascend Anesthesia LLCGroup PAC ID 5294246526, 76 clinicians

Practice addresses (Care Compare)

3929 E Bell Rd
Phoenix, AZ 85032-2112
Phone (623) 923-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
ANT3177982FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascend Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2025 Accepting new patients
Az Care Anesthesia , PLC CurrentSince Jul 5, 2022 Accepting new patients
Dec Anesthesia LLC CurrentSince Apr 1, 2021 Accepting new patients
Summit Anesthesia Services PLLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2021 Accepting new patients
Arizona Digestive Health, PC PastSince Feb 28, 2011 Accepting new patients
Mesa Az Endoscopy ASC LLC PastSince Oct 17, 2021 Accepting new patients
Pinnacle Global Health LLC Past Accepting new patients

Locations

603 W Baseline Rd
Ste 101
Mesa, AZ 85210
Phone (480) 969-0405

1902 W Union Hills Dr
Unit 41340
Phoenix, AZ 85080

2000 W Bethany Home Rd
Phoenix, AZ 85015
Phone (480) 209-4000

3929 E Bell Rd
Phoenix, AZ 85032
Phone (602) 923-5000

1902 W Union Hills Dr
Unit 41550
Phoenix, AZ 85080

13640 N 99th Ave
Ste 600
Sun City, AZ 85351
Phone (623) 523-0580

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1104004894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E 6TH ST",
            "address_2": "SUITE 205",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013661",
            "telephone_number": "850-785-3185",
            "fax_number": "850-785-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E 6TH ST",
            "address_2": "SUITE 205",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013661",
            "telephone_number": "850-785-3185",
            "fax_number": "850-785-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "BRAD",
        "middle_name": "ROBERT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-05",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ANT3177982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "G4459",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "ANT3177982",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.