Individual provider Active NPI

Robert Tyler Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • Birmingham, AL
National Provider Identifier
1366196362
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-145657 Issued in AL
Practice address
1802 6TH Ave S
Birmingham, AL 35233-1932
Phone
(205) 934-3411
NPI assigned
Feb 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 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 1-145657 AL Primary

Addresses

Primary practice location

1802 6TH Ave S
Birmingham, AL 35233-1932

Mailing address

1802 6TH Ave S
Birmingham, AL 35233-1932
Phone (205) 934-3411

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220412000898 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486040854 Reassigns benefits to 3 organizations
Practice locations: Madison, AL

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Alabama School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Best Vein Care of Huntsville, LLCGroup PAC ID 1355691494, 10 clinicians
Varicosity LLCGroup PAC ID 3678541596, 19 clinicians
University of Alabama Health Services Foundation, PCGroup PAC ID 1951213107, 2,784 clinicians

Practice addresses (Care Compare)

1041 Balch Rd
Suite 375
Madison, AL 35758-8820
Phone (256) 258-9940

2704 20TH St S
Suite 100
Homewood, AL 35209-1924
Phone 2055921800209

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

  • University of Alabama Hospital Hospital, Birmingham, AL, CCN 010033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Varicosity LLC CurrentSince Nov 4, 2024 Accepting new patients
Best Vein Care of Huntsville, LLC CurrentSince Mar 9, 2026 Accepting new patients

Locations

2704 20th St S
#100
Homewood, AL 35209
Phone 2053831723225

2010 S Point Park Cir
Apt 170
Huntsville, AL 35801
Phone (256) 715-7151

1041 Balch Rd
Ste 375
Madison, AL 35758
Phone (256) 258-9940

1041 Balch Rd
#375
Madison, AL 35758
Phone (205) 383-1723

1950 Berryhill Rd
Montgomery, AL 36117
Phone 2055921800209

Interoperability endpoints

  • Direct secure messaging: robertjohnson@direct.uabmedicine.org
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1366196362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331932",
            "telephone_number": "205-934-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331932",
            "telephone_number": "205-934-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROBERT",
        "middle_name": "TYLER",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-145657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.