Individual provider Active NPI

Benjamin Tankever Johnson

  • Psychiatry Physician
  • Cheyenne, WY
National Provider Identifier
1235792375
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
16324A Issued in WY
Practice address
2600 E 18TH St
Cheyenne, WY 82001-5511
Phone
(307) 633-7370
Fax
(307) 637-7202
NPI assigned
Apr 15, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 16324A WY Primary

Addresses

Primary practice location

2600 E 18TH St
Cheyenne, WY 82001-5511

Mailing address

13001 E 17TH PL BLDG 500
Aurora, CO 80045-2570
Phone (303) 724-6019

Other practice location 1

13001 E 17th Pl Bldg 500
Aurora, CO 80045-2570
Phone (303) 724-6019

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bjohnson59274@direct.crmcwy.org Direct Memorial Hospital of Laramie County
Direct Messaging Address bjohnson59274@direct.crmcwy.org Health Information Exchange (HIE) Memorial Hospital of Laramie County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20230815003269 WY Practitioner - Psychiatry 7618389867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

214 E 23Rd St
Cheyenne, WY 82001-3748
Phone (307) 634-2273

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16324AWYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital of Laramie County CurrentSince Aug 7, 2023 Accepting new patients

Locations

214 E 23rd St
Cheyenne, WY 82001
Phone (307) 324-2221

2600 E 18th St
Cheyenne, WY 82001
Phone (307) 633-7370

2600 E 18th St
Fl 2
Cheyenne, WY 82001
Phone (307) 633-7321

Organizations & group practices 1

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": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1235792375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13001 E 17TH PL BLDG 500",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452570",
            "telephone_number": "303-724-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 E 18TH ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820015511",
            "telephone_number": "307-633-7370",
            "fax_number": "307-637-7202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13001 E 17th Pl Bldg 500",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452570",
            "country_code": "US",
            "telephone_number": "303-724-6019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BENJAMIN",
        "middle_name": "TANKEVER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-15",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WY",
            "license": "16324A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bjohnson59274@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Memorial Hospital of Laramie County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bjohnson59274@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Memorial Hospital of Laramie County",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.