Active NPI
Curtis C Johnson, MD
- Orthopaedic Hand Surgery Physician
- Provo, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Hand Surgery Physician
- License
- 296076-1205
- Practice address
- 1055 N 500 W Ste 207
Provo, UT 84604-3305 - Phone
- (801) 375-4263
- Fax
- (801) 429-8085
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Hand Surgery Physician | 207XS0106X | 296076-1205 | UT | Primary |
Addresses
Primary practice location
1055 N 500 W Ste 207
Provo, UT 84604-3305
Mailing address
1055 N 500 W
Credentialing Department
Provo, UT 84604-3305
Phone (801) 354-8225
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 870281028000 | Medicaid | UT | |
| 09-00166 | Other | UT | UTAH HEALTHCARE |
| 107007657102 | Other | UT | IHC |
| 68079 | Other | UT | PEHP |
| 870281028CUR | Other | UT | EMIA |
| 228569 | Other | UT | DMBA |
| QM000056633 | Other | UT | ALTIUS |
| 200045126 | Other | UT | PALMETTO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | medreview@reverehealth.com | Revere Health PC |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 296076-1205 | UT | MD | Orthopaedic Hand Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revere Health PC | Current | Accepting new patients | |
| Revere Health PC | Current | Accepting new patients |
Locations
680 W 800 N
#100
Orem, UT 84057
Phone (801) 224-5373
1130 Smith Fieldhouse
Provo, UT 84602
Phone (801) 377-6918
1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000
1055 N 500 W
Ste 205
Provo, UT 84604
Phone (801) 429-8095
1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362
1055 N 300 W
Ste 110
Provo, UT 84604
Phone (801) 357-7377
1055 N 500 W
Ste 207
Provo, UT 84604
Phone (801) 375-4263
555 W State Road 164
Salem, UT 84653
Phone (801) 465-4896
Networks
- UT PPO D-SNP
- UT PPO
Interoperability endpoints
- curtisjohnson@cuccu.allscriptsdirect.net
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Provo, UT
- NPI 1093764805
-
- Multi-Specialty Clinic/Center
- Spanish Fork, UT
- NPI 1851142285
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1205939089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 N 500 W",
"address_2": "CREDENTIALING DEPARTMENT",
"city": "PROVO",
"state": "UT",
"postal_code": "846043305",
"telephone_number": "801-354-8225",
"fax_number": "801-418-0941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 N 500 W STE 207",
"city": "PROVO",
"state": "UT",
"postal_code": "846043305",
"telephone_number": "801-375-4263",
"fax_number": "801-429-8085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "CURTIS",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2023-11-27",
"certification_date": "2020-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": "UT",
"license": "296076-1205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "870281028000",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UTAH HEALTHCARE",
"identifier": "09-00166",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHC",
"identifier": "107007657102",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEHP",
"identifier": "68079",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMIA",
"identifier": "870281028CUR",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMBA",
"identifier": "228569",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALTIUS",
"identifier": "QM000056633",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO",
"identifier": "200045126",
"state": "UT"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "medreview@reverehealth.com",
"affiliation": "Y",
"affiliationName": "Revere Health PC",
"address_1": "1055 N 500 W Ste 207",
"city": "Provo",
"state": "UT",
"country_code": "US",
"postal_code": "846043305",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.