Individual provider Active NPI

Sherman Bennion Johnson, M.D.

  • Pediatrics Physician
  • Taylorsville, UT
National Provider Identifier
1376510800
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
1646671205 Issued in UT
Practice address
2520 W 4700 S
#5A
Taylorsville, UT 84129-1847
Phone
(801) 964-2008
Fax
(801) 964-2435
NPI assigned
Mar 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 1646671205 UT Primary

Addresses

Primary practice location

2520 W 4700 S
#5A
Taylorsville, UT 84129-1847

Mailing address

2520 W 4700 S
#5A
Taylorsville, UT 84129-1847
Phone (801) 964-2008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1646671205UTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dudley Chiropractic & Wellness Center LC CurrentSince May 20, 2013 Accepting new patients
Wasatch Hyperbaric Center Inc Past Accepting new patients
Worksite Wellness Past Accepting new patients

Locations

2505 E 3300 S
Ste 201
Salt Lake Cty, UT 84109
Phone (801) 359-3995

2520 W 4700 S
Ste 2A
Taylorsville, UT 84129
Phone (801) 964-2008

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.

NPI Registry JSON

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1376510800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 W 4700 S",
            "address_2": "#5A",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841291847",
            "telephone_number": "801-964-2008",
            "fax_number": "801-964-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 W 4700 S",
            "address_2": "#5A",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841291847",
            "telephone_number": "801-964-2008",
            "fax_number": "801-964-2435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHERMAN",
        "middle_name": "BENNION",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "1646671205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylorsville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.