Active NPI
Bradley Scott Johnson, DO
- Urology Physician
- Lansing, MI
National Provider Identifier
1417528357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 1417528357
- Practice address
- 1140 E Michigan Ave
Lansing, MI 48912-1805 - Phone
- (517) 364-5655
- NPI assigned
- Jul 1, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | M083810221 | OK | |
| Urology Physician | 208800000X | 1417528357 | MI | Primary |
Addresses
Primary practice location
1140 E Michigan Ave
Lansing, MI 48912-1805
Mailing address
1140 E Michigan Ave
Lansing, MI 48912-1805
Phone (517) 364-5655
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1417528357 | MI | MD | Urology Physician |
| M083810221 | OK | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776816000000",
"number": "1417528357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1140 E MICHIGAN AVE",
"city": "LANSING",
"state": "MI",
"postal_code": "489121805",
"telephone_number": "517-364-5655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1140 E MICHIGAN AVE",
"city": "LANSING",
"state": "MI",
"postal_code": "489121805",
"telephone_number": "517-364-5655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "BRADLEY",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-01",
"last_updated": "2026-04-22",
"certification_date": "2026-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "OK",
"license": "M083810221",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "MI",
"license": "1417528357",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.