Individual provider Active NPI

Corey Dean Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • Pullman, WA
National Provider Identifier
1447235353
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP60160350 Issued in WA
Practice address
835 SE Bishop Blvd
Pullman, WA 99163-5512
Phone
(509) 332-4051
Fax
(509) 332-4051
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP60160350 WA Primary

Addresses

Primary practice location

835 SE Bishop Blvd
Pullman, WA 99163-5512

Mailing address

PO Box 487
Pullman, WA 99163-0487
Phone (509) 332-4051

Other practice location 1

825 SE Bishop Blvd Ste 140
Pullman, WA 99163-5517
Phone (509) 336-7725

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110509000656 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466638499 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

835 SE Bishop Blvd
Pullman, WA 99163-5512
Phone (509) 332-2541

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District #1-a of Whitman County CurrentSince Feb 1, 2021 Accepting new patients
Public Hospital District #1-a of Whitman County Past Accepting new patients
Douglas G Demmert Crna Nurse Anesthetist, Certified Registered Past Accepting new patients
David M Brown, Crna PS Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

825 SE Bishop Blvd
Ste 201
Pullman, WA 99163
Phone (509) 336-7577

835 SE Bishop Blvd
Pullman, WA 99163
Phone (509) 332-2541

825 SE Bishop Blvd
Ste 140
Pullman, WA 99163
Phone (509) 334-4498

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1447235353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 487",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991630487",
            "telephone_number": "509-332-4051",
            "fax_number": "509-332-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 SE BISHOP BLVD",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635512",
            "telephone_number": "509-332-4051",
            "fax_number": "509-332-4051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 SE Bishop Blvd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Pullman",
            "state": "WA",
            "postal_code": "991635517",
            "country_code": "US",
            "telephone_number": "509-336-7725",
            "fax_number": "509-538-5919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "COREY",
        "middle_name": "DEAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60160350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pullman, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.