Marty J Johnson, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11099893-4405 Issued in UT

Practice address

185 S 400 E Ste 100
Bountiful, UT 84010-4862

Phone

(801) 475-3482

NPI assigned

Feb 22, 2024

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ogden Clinic PCGroup PAC ID 9638078033, 104 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakeview Hospital Hospital, Bountiful, UT, CCN 460042

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA

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.

• Ogden Clinic PC

  • Family Medicine Physician
  • Ogden, UT
  • NPI 1578550083

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Ogden Clinic Specialty Services LLC

  dba Ogden Clinic PC

  • Sports Medicine (Family Medicine) Physician
  • Ogden, UT
  • NPI 1114203668
  NPD

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

• Hospital Corporation of Utah

  dba Lakeview Hospital

  • General Acute Care Hospital
  • Bountiful, UT
  • NPI 1528010451
  Care Compare affiliation

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

{
    "created_epoch": "1708560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1215793799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-475-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 S 400 E STE 100",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104862",
            "telephone_number": "801-475-3482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARTY",
        "middle_name": "J",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "11099893-4405",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "11099893-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony David Johnson
• Ava Ellen Johnson
• Clinton Johnson, D.O.
• Hannah Melelani Myers Johnson, MA
• Lily Johnson
• Paul Johnson, M.D.
• Rebekah Dru Johnson, DNP, FNP, RN
• Toni Johnson
• Bracken Conner Jolley
• Curtis Brian Jolley, PT MOMT

• Nurse Practitioner in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.