Stephen C. Johnson, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

18166 Issued in NE

Practice address

4021 Avenue B
Scottsbluff, NE 69361-4602

Phone

(303) 761-9190

Fax

(720) 874-4462

NPI assigned

Sep 30, 2005

Last updated

Apr 7, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NE

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Radiology Imaging of Nebraska, LLC

  • Diagnostic Radiology Physician
  • Scottsbluff, NE
  • NPI 1184869901
  Medicare reassignment NPD
• Radiology Imaging Associates, PC

  • Diagnostic Radiology Physician
  • Englewood, CO
  • NPI 1679513196

  NE

  Medicare reassignment NPD
• Medical Imaging Associates PC

  • Diagnostic Radiology Physician
  • Scottsbluff, NE
  • NPI 1134173685
  NPD (past) Authorized official

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1235126780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 E GEDDES AVE",
            "address_2": "SUITE 200",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801123800",
            "telephone_number": "303-761-9190",
            "fax_number": "720-874-4462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 AVENUE B",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614602",
            "telephone_number": "303-761-9190",
            "fax_number": "720-874-4462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STEPHEN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "18166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025709000",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235126780/7726960",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235126780",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR NE",
            "identifier": "P00720335",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn Joy Johnson, COTA
• Jan E Johnson, RN,MS,CS
• Jasmine Marie Johnson
• Karen Ruth Johnson, RD, LMNT
• Karissa A Johnson, M.D.
• Tara Johnson
• Carolyn Sue Jones, RN LIMHP
• Douglas Brenner Jones, ATC
• John David Jones III
• Wendy Rae Juarez

• Diagnostic Radiology Physician in Scottsbluff, NE
• Providers in Scottsbluff, NE by specialty
• Diagnostic Radiology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; 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.

Verify at the official NPI Registry.