Individual provider Active NPI

Bryant Lowell Johnson, D.O.

  • Obstetrics & Gynecology Physician
  • Layton, UT
National Provider Identifier
1205214772
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
10879391-1204 Issued in UT
Practice address
2121 N 1700 W
Layton, UT 84041-8803
Phone
(801) 773-4840
Fax
(801) 525-8151
NPI assigned
May 15, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 10879391-1204 UT Primary

Addresses

Primary practice location

2121 N 1700 W
Layton, UT 84041-8803

Mailing address

PO Box 337
Layton, UT 84041-0337
Phone (801) 773-4840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190703002060 UT Practitioner - Obstetrics/Gynecology 0749599439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Memorial ClinicGroup PAC ID 4284547985, 251 clinicians

Practice addresses (Care Compare)

2121 N 1700
Layton, UT 84041-8803
Phone (801) 773-4840

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Memorial Clinic CurrentSince Jul 1, 2019 Accepting new patients
Tanner Memorial Clinic CurrentSince Jul 1, 2019 Accepting new patients
Tanner Memorial Clinic Obstetrics & Gynecology Current Accepting new patients
Rosenberg Cooley Metcalf LC Past Accepting new patients

Locations

1756 W Antelope Dr
Layton, UT 84041
Phone (801) 525-8726

Networks

  • UT PPO
  • UT PPO D-SNP

Interoperability endpoints

  • Direct secure messaging: bryant.johnson.p1@direct.tannerclinic.nextgenshare.com

Organizations & group practices 4

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": "1431648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1205214772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840410337",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 N 1700 W",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840418803",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRYANT",
        "middle_name": "LOWELL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-15",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "10879391-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.