Glen Eric Johnson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

1547641205 Issued in UT

Practice address

3940 West 4100 South
West Valley City, UT 84120

Phone

(801) 966-3700

Fax

(801) 966-9421

NPI assigned

Aug 30, 2006

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

Psychiatry

Education

University of Wisconsin School of Medicine, 1971

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Harvey L Rishe Acsw PHD PC

  • Psychologist
  • West Valley City, UT
  • NPI 1720352297
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1326157298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E 4500 S",
            "address_2": "C-150",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841074533",
            "telephone_number": "801-288-0747",
            "fax_number": "801-288-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3940 WEST 4100 SOUTH",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "84120",
            "telephone_number": "801-966-3700",
            "fax_number": "801-966-9421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GLEN",
        "middle_name": "ERIC",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "1547641205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jovie Lou Jessop
• Annalise John, LCSW
• Ashley Johnson, PA-C
• Briana Dawn Johnson, PA
• Elaina Johnson
• Leeann Johnson, FNP
• Matthew B Johnson, M.D.
• Tami Johnson
• Alexis Lauren Jones, APRN
• Kelsey Jones, LMT

• Psychiatry Physician in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Psychiatry Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.
• 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.