Individual provider Active NPI

Casey Michael Johnston, DC

  • Chiropractor
  • Gilbert, AZ
National Provider Identifier
1386638294
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7458 Issued in AZ
Practice address
904 N McQueen Rd Ste 103
Gilbert, AZ 85233-2285
Phone
(480) 668-1199
Fax
(480) 668-7300
NPI assigned
Sep 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7458 AZ Primary

Addresses

Primary practice location

904 N McQueen Rd Ste 103
Gilbert, AZ 85233-2285

Mailing address

904 N McQueen Rd Ste 103
Gilbert, AZ 85233-2285
Phone (480) 668-1199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061222000268 AZ Practitioner - Chiropractic 9436159498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellness Dynamics LLCGroup PAC ID 5890797666, 3 clinicians

Practice addresses (Care Compare)

904 N McQueen Rd
Suite 103
Gilbert, AZ 85233-2285
Phone (480) 668-1199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7458AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Dynamics LLC Chiropractor CurrentSince May 1, 2006 Accepting new patients

Locations

904 N McQueen Rd
Ste 103
Gilbert, AZ 85233
Phone (480) 207-3344

127 W Juanita Ave
Ste 110
Mesa, AZ 85210
Phone (480) 613-4406

Organizations & group practices 1

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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1386638294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 N MCQUEEN RD STE 103",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852332285",
            "telephone_number": "480-668-1199",
            "fax_number": "480-668-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 N MCQUEEN RD STE 103",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852332285",
            "telephone_number": "480-668-1199",
            "fax_number": "480-668-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "CASEY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.