Jason Lynn Johnson, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

95295445-1205 Issued in UT

Practice address

1140 E 3900 S
Ste 400
Salt Lake City, UT 84124-1228

Phone

(801) 268-6811

Fax

(801) 268-8673

NPI assigned

Oct 3, 2006

Last updated

Mar 7, 2023By 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

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

University of Minnesota Medical School, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Mark's Gynecology Oncology Care LLCGroup PAC ID 4486736279, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mark's Hospital Hospital, Salt Lake City, UT, CCN 460047

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• St. Mark's Gynecology Oncology Care LLC

  • Gynecologic Oncology Physician
  • Salt Lake City, UT
  • NPI 1053593921
  Medicare reassignment Care Compare group

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

• Northern Utah Healthcare Corporation

  dba St. Mark's Hospital

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1164469243
  Care Compare affiliation

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1376638718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198546",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 E 3900 S",
            "address_2": "STE 400",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241228",
            "telephone_number": "801-268-6811",
            "fax_number": "801-268-8673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JASON",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-03-07",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "95295445-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "46D0704114",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "87-0280366",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjohnson19845@epicmtn.hcadirect.net",
            "affiliation": "N",
            "address_1": "1140 E 3900 S",
            "address_2": "STE 400",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841241228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jade Johnson
• Jade Johnson
• Jaden Stanley Johnson
• James Grant Johnson, MSW LCSW
• Jamie Johnson
• Jeff Johnson, PHARMD
• Jennifer D Johnson, LCSW
• Jessica Johnson, TRT
• Jessica Johnson, M.D.
• Jessica Johnson, CSW

• Obstetrics & Gynecology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Obstetrics & Gynecology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.