Active NPI
David C Johnson, DC, MUAC
- Chiropractor
- Glendale, AZ
National Provider Identifier
1417004615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5344
- Practice address
- 5930 W Greenway Rd Ste 26
Glendale, AZ 85306-3291 - Phone
- (602) 765-9736
- Fax
- (602) 942-2106
- NPI assigned
- Jan 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5344 | AZ | Primary |
Addresses
Primary practice location
5930 W Greenway Rd Ste 26
Glendale, AZ 85306-3291
Mailing address
4410 W Union Hills Dr Ste 7
309
Glendale, AZ 85308-1656
Phone (602) 765-9736
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AZ0242661 | Other | AZ | AZ BLUE CROSS BLUE SHIELD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5344 | AZ | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Performance Plus Chiropractic LLC | Chiropractor | Past | Accepting new patients |
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.
-
- Chiropractor
- Glendale, AZ
- NPI 1821302985
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280620800000",
"number": "1417004615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4410 W UNION HILLS DR STE 7",
"address_2": "309",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853081656",
"telephone_number": "602-765-9736",
"fax_number": "602-942-2106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5930 W GREENWAY RD STE 26",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853063291",
"telephone_number": "602-765-9736",
"fax_number": "602-942-2106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "DAVID",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "DC, MUAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2010-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AZ",
"license": "5344",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AZ BLUE CROSS BLUE SHIELD",
"identifier": "AZ0242661",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.