Individual provider Active NPI

Clifford Dean Johnson, M.D.

  • Family Medicine Physician
  • Westminster, CO
National Provider Identifier
1154499234
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR0053168 Issued in CO
Practice address
10485 N. Sheridan Blvd
Suite 200
Westminster, CO 80020
Phone
(303) 466-8344
Fax
(833) 795-1962
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0421454 KS
Family Medicine Physician 207Q00000X DR0053168 CO Primary

Addresses

Primary practice location

10485 N. Sheridan Blvd
Suite 200
Westminster, CO 80020

Mailing address

10485 N. Sheridan Blvd
Suite 200
Westminster, CO 80020
Phone (303) 466-8344

Other identifiers 1

IdentifierTypeStateIssuer
100135680BMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR0053168COMDFamily Medicine Physician
0421454KSMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: clifford.johnson.1@23284.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1154499234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10485 N. SHERIDAN BLVD",
            "address_2": "SUITE 200",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "80020",
            "telephone_number": "303-466-8344",
            "fax_number": "833-795-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10485 N. SHERIDAN BLVD",
            "address_2": "SUITE 200",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "80020",
            "telephone_number": "303-466-8344",
            "fax_number": "833-795-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CLIFFORD",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0421454",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR0053168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100135680B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.