Gary Blake Johnson, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

5860718-1205 Issued in UT

Practice address

24 S 1100 E Ste 105
Salt Lake City, UT 84102-1593

Phone

(801) 965-3600

NPI assigned

May 24, 2005

Last updated

Feb 4, 2025By 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 UT, WY, ID3 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

Specialty

Urology

Education

New York Medical College, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Lincoln County Hospital DistrictGroup PAC ID 4789580218, 66 clinicians

Granger Medical Clinic PCGroup PAC ID 3476465691, 192 clinicians

Memorial Hospital of Laramie CountyGroup PAC ID 1557357555, 49 clinicians

Tooele Urology LLCGroup PAC ID 8426108192, 3 clinicians

Teton County Hospital DistrictGroup PAC ID 4880582295, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Star Valley Medical Center Hospital, Afton, WY, CCN 531313
• Holy Cross Hospital - Salt Lake Hospital, Salt Lake City, UT, CCN 460003
• Intermountain Medical Center Hospital, Murray, UT, CCN 460010
• St Johns Medical Center Hospital, Jackson, WY, CCN 530015
• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• UT PPO D-SNP
• UT PPO

Interoperability endpoints

• Direct secure messaging: bjohnson623297@direct.ochin.org
• Direct secure messaging: gary.johnson.1@17373.direct.athenahealth.com
• Direct secure messaging: gary.johnson@gmcwv.eclinicaldirectplus.com
• Direct secure messaging: gbjohnso@yourcarecommunity.org

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.

• Tooele Urology LLC

  • Medical Specialty Clinic/Center
  • South Jordan, UT
  • NPI 1457599912
  Medicare reassignment Care Compare group NPD
• Memorial Hospital of Laramie County

  dba Cheyenne Regional Medical Center

  • General Acute Care Hospital
  • Cheyenne, WY
  • NPI 1285621839
  Medicare reassignment Care Compare group NPD
• North Lincoln County Hospital District

  dba Star Valley Medical Center

  • Family Medicine Physician
  • Afton, WY
  • NPI 1730132523
  Medicare reassignment Care Compare group NPD
• Teton County Hospital District

  dba St John's Health

  • General Practice Physician
  • Jackson, WY
  • NPI 1487818605
  Medicare reassignment Care Compare group NPD
• Granger Medical Clinic PC

  • Multi-Specialty Clinic/Center
  • West Valley City, UT
  • NPI 1184657041
  Medicare reassignment Care Compare group
• Granger Medical Specialists LLC

  • Clinic/Center
  • West Valley City, UT
  • NPI 1376159368
  Medicare reassignment NPD
• Evanston Clinic Corp

  • Family Medicine Physician
  • Evanston, WY
  • NPI 1013916519

  Urology

  Medicare reassignment NPD
• Franklin County Medical Center

  dba FCMC Specialty Clinic

  • Critical Access Hospital
  • Preston, ID
  • NPI 1548355811
  Medicare reassignment NPD
• Utah Urology Works LLC

  • Urology Physician
  • Murray, UT
  • NPI 1154945061
  NPD Authorized official
• Granger Medical Clinic Inc

  dba Granger Medical Riverton

  • Multi-Specialty Clinic/Center
  • Riverton, UT
  • NPI 1881797876
  NPD
• Granger Medical Specialists, LLC

  • Multi-Specialty Clinic/Center
  • Salt Lake City, UT
  • NPI 1497441539
  NPD
• Franklin County Medical Center

  dba Franklin County Medical Center Home Health and Hospice

  • Home Health Agency
  • Preston, ID
  • NPI 1437927431
  NPD

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

• Catholic Health Initiatives Colorado

  dba Holy Cross Hospital - Salt Lake

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1043915523
  Care Compare affiliation
• Ihc Health Services, Inc.

  dba Intermountain Health Intermountain Medical Center

  • General Acute Care Hospital
  • Murray, UT
  • NPI 1043220650
  Care Compare affiliation
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation
• North Lincoln County Hospital District

  dba Star Valley Medical Center

  • Critical Access Hospital
  • Afton, WY
  • NPI 1255376406
  Care Compare affiliation
• Teton County Hospital District

  dba St John's Medical Center/ or St John's Health

  • General Acute Care Hospital
  • Jackson, WY
  • NPI 1801835475
  Care Compare affiliation

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1144223827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193602",
            "telephone_number": "801-965-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 S 1100 E STE 105",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021593",
            "telephone_number": "801-965-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GARY",
        "middle_name": "BLAKE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "5860718-1205",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "UT",
            "license": "5860718-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Johnson, MD
• Emma Johnson, DPT
• Eric Johnson, M.D.
• Frances Millett Johnson, FNP-C
• Gary Johnson
• Hannah Johnson
• Heather Spencer Johnson
• Heidi Johnson, CPSS
• Hilary Johnson
• Ian Johnson

• Urology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Urology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.