Individual provider Active NPI

Mandy J Johnson, WHNP

  • Women's Health Nurse Practitioner
  • Murray, UT
National Provider Identifier
1245406347
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
362724-4405 Issued in UT
Practice address
166 E 5900 S
B-104
Murray, UT 84107-7257
Phone
(801) 265-1266
Fax
(801) 265-0755
NPI assigned
May 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 362724-4405 UT Primary

Addresses

Primary practice location

166 E 5900 S
B-104
Murray, UT 84107-7257

Mailing address

166 East 5900 South
B-104
Murray, UT 84107-7257
Phone (801) 265-1266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
362724-4405UTMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Lakeview Hospital Past Accepting new patients
Utah Fertility Center Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210204800000",
    "number": "1245406347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 EAST 5900 SOUTH",
            "address_2": "B-104",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077257",
            "telephone_number": "801-265-1266",
            "fax_number": "801-265-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 E 5900 S",
            "address_2": "B-104",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077257",
            "telephone_number": "801-265-1266",
            "fax_number": "801-265-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MANDY",
        "middle_name": "J",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-08",
        "last_updated": "2008-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "UT",
            "license": "362724-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.