NPIMap

Individual provider Active NPI

Olivia Johnson, MD

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1427638733
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
16652A Issued in WY
Practice address
1300 N 12TH St Ste 508
Phoenix, AZ 85006-2849
Phone
(602) 839-3927
NPI assigned
Apr 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 16652A WY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1300 N 12TH St Ste 508
Phoenix, AZ 85006-2849

Mailing address

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (602) 839-3644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240924001607 WY Practitioner - Internal Medicine 2668878547 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Washington School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Physicians of Wyoming LLCGroup PAC ID 8325214828, 41 clinicians
Billings ClinicGroup PAC ID 6002993516, 814 clinicians

Practice addresses (Care Compare)

1233 E 2ND St
Casper, WY 82601-2926
Phone (800) 822-7201

201 Yellowstone Ave
Cody, WY 82414-9313
Phone (307) 527-7561

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16652AWYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Billings Clinic Internal Medicine CurrentSince Dec 22, 2025 Accepting new patients
Sound Physicians of Wyoming, LLC Internal Medicine CurrentSince Jul 18, 2024 Accepting new patients
Billings Clinic Internal Medicine CurrentSince Dec 22, 2025 Accepting new patients
Wyoming Medical Center Inc Past Accepting new patients

Locations

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

1233 E 2nd St
Casper, WY 82601
Phone (307) 577-2171

707 Sheridan Ave
Cody, WY 82414
Phone (307) 527-7561

201 Yellowstone Ave
Cody, WY 82414
Phone (307) 527-7561

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/dcf3b1c6-3971-4673-962e-8b2cce0ff827/

Organizations & group practices 4

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1618099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1427638733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612",
            "telephone_number": "602-839-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST STE 508",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062849",
            "telephone_number": "602-839-3927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "OLIVIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-11",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WY",
            "license": "16652A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.