Individual provider Active NPI

Benton Johnson, MD

  • Diagnostic Radiology Physician
  • Aurora, CO
National Provider Identifier
1467868935
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
62158 Issued in CO
Practice address
12605 E 16TH Ave
Aurora, CO 80045-2545
Phone
(720) 848-0000
NPI assigned
Jul 7, 2014
Last updated
Jul 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LL36899 SC
Diagnostic Radiology Physician 2085R0202X 62158 CO Primary

Addresses

Primary practice location

12605 E 16TH Ave
Aurora, CO 80045-2545

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200406003421 GA Practitioner - Diagnostic Radiology 7810286093 Reassigns benefits to 3 organizations
I20240807004117 SC Practitioner - Diagnostic Radiology 7810286093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical University of South Carolina College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stephen W Brown and Radiology Associates of Augusta LLPGroup PAC ID 0244293322, 19 clinicians

Practice addresses (Care Compare)

302 University Pkwy
Aiken, SC 29801-6302
Phone (803) 644-1357

4350 Towne Centre Dr
Suite 1000
Evans, GA 30809-3328
Phone (706) 868-3940

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36899SCMDPharmacist
62158COMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Sep 30, 2022 Accepting new patients
Evans Imaging, LLC CurrentSince Jul 6, 2020 Accepting new patients
Stephen W. Brown and Radiology Associates of Augusta LLP Diagnostic Radiology CurrentSince May 1, 2020 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Mar 17, 2024 Accepting new patients
Au Health Imaging, LLC Diagnostic Radiology CurrentSince Sep 30, 2022 Accepting new patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients
Wellstar Medical Group, LLC Family Medicine CurrentSince Mar 17, 2024 Accepting new patients
Au Medical Associates Inc CurrentSince Sep 30, 2022 Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1125 Troupe St
Augusta, GA 30904
Phone (706) 738-7977

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

2260 Wrightsboro Rd
Augusta, GA 30904
Phone (706) 481-7000

3610 Wheeler Rd
Augusta, GA 30909
Phone (706) 210-9500

3624 J Dewey Gray Cir
Ste 100
Augusta, GA 30909
Phone (706) 561-6501

3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232

818 Saint Sebastian Way
Ste 100
Augusta, GA 30901
Phone (706) 722-3574

4350 Towne Centre Dr
Evans, GA 30809
Phone (706) 724-4400

4350 Towne Centre Dr
Ste 1000
Evans, GA 30809
Phone (706) 868-3940

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

2460 Washington Rd
Thomson, GA 30824
Phone (706) 595-1411

351 S Liberty St
Waynesboro, GA 30830
Phone (706) 554-4435

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

Organizations & group practices 8

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 7

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": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1467868935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12605 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452545",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BENTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-07",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL36899",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "62158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.