Bryan Johnson, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT91917 Issued in TX

Practice address

771 E Southlake Blvd Ste 106
Southlake, TX 76092-6354

Phone

(469) 372-2022

Fax

(833) 290-5413

NPI assigned

Feb 14, 2025

Last updated

Feb 14, 2025By 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

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Doherty Nutrition LLCGroup PAC ID 0941610273, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Doherty Nutrition LLC

  • Registered Dietitian
  • Dallas, TX
  • NPI 1326502832

  Dietitian, Registered

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1739491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1306641220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17060 DALLAS PKWY STE 112",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481905",
            "telephone_number": "469-372-2022",
            "fax_number": "833-290-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 E SOUTHLAKE BLVD STE 106",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926354",
            "telephone_number": "469-372-2022",
            "fax_number": "833-290-5413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17060 Dallas Pkwy Ste 112",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752481905",
            "country_code": "US",
            "telephone_number": "469-372-2022",
            "fax_number": "833-290-5413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRYAN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-14",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT91917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mona Lisa Jimenez, PMHNP-BC
• Jeanne Marsh Joglar, MD
• John Ryan Price, D.C., P.a. (Premier Chiropractic of Southlake)
• Abigail Grace John, APRN, FNP-BC, NP-C
• Barbara S Johnson, PMHNP
• David O Johnson, M.D.
• Deborah KB Johnson, M.A. CCC-SLP
• Monica J Johnson, O.T.
• Neysa L. Johnson, M.D.
• Heather Elizabeth Johnston, ACNP-BC

• Registered Dietitian in Southlake, TX
• Providers in Southlake, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; 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.