NPIMap

Individual provider Active NPI

Christopher L Johnson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Rolla, MO
National Provider Identifier
1154337202
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
000803 Issued in MO
Practice address
1050 W 10TH St
Rolla, MO 65401-2905
Phone
(573) 364-9000
Fax
(573) 426-2108
NPI assigned
Jul 31, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 000803 MO Primary

Addresses

Primary practice location

1050 W 10TH St
Rolla, MO 65401-2905

Mailing address

1050 W 10TH St
Attn: Executive Director of Physician Clinics
Rolla, MO 65401-2905
Phone (573) 364-9000

Other practice location 1

1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 364-9000

Other practice location 2

1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 458-8899

Other practice location 3

1415 W Scenic Rivers Blvd
Salem, MO 65560-2840
Phone (573) 729-5533

Other practice location 4

1000 GW Ln
Waynesville, MO 65583-2339
Phone (573) 774-2715

Other identifiers 5

IdentifierTypeStateIssuer
365905405MedicaidMO
365905413MedicaidMO
30531900MedicaidMO
305351926MedicaidMO
305351918MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041020001018 MO Practitioner - Podiatry 0749241073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pcrmc Medical Group IncGroup PAC ID 1557454063, 113 clinicians

Practice addresses (Care Compare)

1000 GW LN
Waynesville, MO 65583-2339
Phone (573) 842-4116

1000 W 10TH St
Rolla, MO 65401-2905
Phone (573) 364-9000

1050 W 10TH St
Rolla, MO 65401-2905
Phone (573) 364-9000

1060 W 10TH St
Rolla, MO 65401-2905
Phone (855) 406-3324

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue41
Removal of nail tissue1082
Removal or shaving of skin growth566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000803MOMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pcrmc Medical Group, Inc CurrentSince Jan 1, 2012 Accepting new patients
Phelps County Regional Medical Center CurrentSince Jan 1, 2012 Accepting new patients
Phelps County Regional Medical Center CurrentSince Jun 24, 2023 Accepting new patients
Mid-West Podiatry & Associates LLC Foot & Ankle Surgery Past Accepting new patients
Saint Louis Connectcare Past Accepting new patients
Mid-West Podiatry and Associates, LLC Foot & Ankle Surgery PastSince Apr 7, 1997 Accepting new patients
Achilles Foot & Ankle Surgery PC Foot & Ankle Surgery Past Accepting new patients
Achilles Foot & Ankle Surgery PC Foot & Ankle Surgery Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

1050 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

1415 W Scenic Rivers Blvd
Salem, MO 65560
Phone (573) 729-5533

1000 Gw Ln
Waynesville, MO 65583
Phone (573) 774-2715

Organizations & group practices 9

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 9

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1154337202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W 10TH ST",
            "address_2": "ATTN: EXECUTIVE DIRECTOR OF PHYSICIAN CLINICS",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-364-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-364-9000",
            "fax_number": "573-426-2108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "MO",
            "postal_code": "654012905",
            "country_code": "US",
            "telephone_number": "573-364-9000",
            "fax_number": "573-426-2108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "MO",
            "postal_code": "654012905",
            "country_code": "US",
            "telephone_number": "573-458-8899",
            "fax_number": "573-341-5611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1415 W Scenic Rivers Blvd",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "MO",
            "postal_code": "655602840",
            "country_code": "US",
            "telephone_number": "573-729-5533",
            "fax_number": "573-202-2466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 GW Ln",
            "address_purpose": "LOCATION",
            "city": "Waynesville",
            "state": "MO",
            "postal_code": "655832339",
            "country_code": "US",
            "telephone_number": "573-774-2715",
            "fax_number": "573-202-2410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "000803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "365905405",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "365905413",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30531900",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305351926",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305351918",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, MO

Sources for this page

Verify at the official NPI Registry.