Individual provider Active NPI

David L Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • Jber, AK
National Provider Identifier
1346211166
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9245841 Issued in FL
Practice address
673 MDG
5955 Zeamer Avenue
Jber, AK 99506
Phone
(907) 580-1815
NPI assigned
Jan 30, 2006
Last updated
May 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 9245841 FL Primary

Addresses

Primary practice location

673 MDG
5955 Zeamer Avenue
Jber, AK 99506

Mailing address

340 Boatner Rd
Eglin AFB, FL 32542-1391
Phone (850) 883-9658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, AK, FL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20161111001181 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840398996 Reassigns benefits to 1 organization
I20240607000805 AK Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840398996 Reassigns benefits to 1 organization
I20241025001658 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840398996 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians

Practice addresses (Care Compare)

110 N Lecanto Hwy
Lecanto, FL 34461-9190
Phone (352) 527-1825

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9245841FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Lights Anesthesia LLC CurrentSince May 1, 2024 Accepting new patients
University of Alabama at Birmingham Current Accepting new patients
Jax Anesthesia Providers LLC CurrentSince Aug 19, 2024 Accepting new patients
University of Alabama at Birmingham Nurse Anesthetist, Certified Registered CurrentSince Sep 17, 2016 Accepting new patients
University of Alabama at Birmingham CurrentSince Sep 17, 2016 Accepting new patients
Palmer Pain and Headache LLC CurrentSince Jul 1, 2024 Accepting new patients
West Florida Medical Center Clinic PA Past Accepting new patients

Locations

1150 S Colony Way
Palmer, AK 99645
Phone (907) 715-6300

1150 S Colony Way
Ste 3
Palmer, AK 99645

1901 N Hemmer Rd
Apt 111
Palmer, AK 99645
Phone (907) 745-8000

619 19th St S
Rm JT845
Birmingham, AL 35249
Phone (205) 934-7072

4800 Belfort Rd
Jacksonville, FL 32256
Phone (904) 307-2084

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1346211166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 BOATNER RD",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421391",
            "telephone_number": "850-883-9658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "673 MDG",
            "address_2": "5955 ZEAMER AVENUE",
            "city": "JBER",
            "state": "AK",
            "postal_code": "99506",
            "telephone_number": "907-580-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9245841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jber, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.