Individual provider Active NPI

Craig Marshall Johnson

  • Certified Registered Nurse Anesthetist
  • Colton, CA
National Provider Identifier
1295236388
Registry record updated Sep 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95000907 Issued in CA
Practice address
400 N Pepper Ave
Colton, CA 92324-1801
Phone
(909) 580-1000
NPI assigned
Feb 23, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 795907 CA
Certified Registered Nurse Anesthetist 367500000X 121027 CA
Certified Registered Nurse Anesthetist 367500000X 95000907 CA Primary

Addresses

Primary practice location

400 N Pepper Ave
Colton, CA 92324-1801

Mailing address

444 S Eureka St
Redlands, CA 92373-5908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181105000755 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406109602 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mission Nursing Anesthesia IncGroup PAC ID 9436459278, 43 clinicians

Practice addresses (Care Compare)

35800 Bob Hope Dr
Suite 100
Rancho Mirage, CA 92270-1739
Phone (760) 699-6500

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
795907CAMDRegistered Nurse
121027CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Mar 16, 2022 Accepting new patients
Mission Nursing Anesthesia, Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 15, 2018 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Mar 16, 2022 Accepting new patients
Sda Services of Ca CurrentSince Jan 14, 2026 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients

Locations

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886

35800 Bob Hope Dr
Ste 100
Rancho Mirage, CA 92270
Phone (760) 699-5000

39700 Bob Hope Dr
Ste 204
Rancho Mirage, CA 92270
Phone (760) 346-3641

2006 N Riverside Ave
Ste C
Rialto, CA 92377
Phone (909) 586-6238

3762 Tibbetts St
Riverside, CA 92506
Phone (951) 686-2224

Organizations & group practices 5

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": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1295236388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 S EUREKA ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CRAIG",
        "middle_name": "MARSHALL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-23",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "795907",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "121027",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95000907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.