Individual provider Active NPI

Gregory J Johnson

  • Certified Registered Nurse Anesthetist
  • Mount Pleasant, WI
National Provider Identifier
1477031557
Registry record updated Jun 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11020093 Issued in FL
Practice address
3801 Spring St
Mount Pleasant, WI 53405
Phone
(262) 687-4011
NPI assigned
Aug 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 243351-30 WI
Certified Registered Nurse Anesthetist 367500000X APRN11020093 FL Primary

Addresses

Primary practice location

3801 Spring St
Mount Pleasant, WI 53405

Mailing address

PO Box 322
Port Sanilac, MI 48469-0322
Phone (810) 300-8595

Other practice location 1

2815 S Seacrest Blvd
Boynton Beach, FL 33435-7969
Phone (561) 737-7733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181129000061 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901140128 Reassigns benefits to 2 organizations
I20220629002914 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901140128 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians
Racine Anesthesia Services LLCGroup PAC ID 8628103777, 81 clinicians

Practice addresses (Care Compare)

3231 McMullen Booth Rd
Safety Harbor, FL 34695-6607
Phone (727) 725-6526

3801 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-4392

Hospital & facility affiliations

  • Mease Countryside Hospital Hospital, Safety Harbor, FL, CCN 100265
  • Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
243351-30WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Florida Anesthesiologists, LLC CurrentSince Oct 1, 2023 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Dec 30, 2024 Accepting new patients
Racine Anesthesia Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2018 Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Jupiter Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2023 Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 14, 2022 Accepting new patients
Anesthesia Partners Services, S.C. CurrentSince Dec 13, 2021 Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Jun 14, 2022 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Dec 30, 2024 Accepting new patients
Greater Florida Anesthesiologists, LLC CurrentSince Oct 1, 2023 Accepting new patients
Jupiter Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2023 Accepting new patients
Greater Florida Anesthesiologists, LLC Current Accepting new patients
Laboratory Corportation of America Holdings Past Accepting new patients

Locations

2815 S Seacrest Blvd
Boynton Beach, FL 33435
Phone (561) 732-1277

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

2140 W 68th St
Hialeah, FL 33016
Phone (305) 822-4107

1210 S Old Dixie Hwy
Jupiter, FL 33458
Phone (561) 743-5073

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

401 NW 42nd Ave
Plantation, FL 33317
Phone (954) 513-6434

460 N State Road 7
Royal Palm Beach, FL 33411
Phone (561) 792-7333

900 Carillon Pkwy
Ste 205
St Petersburg, FL 33716
Phone (727) 561-2710

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

2044 Trinity Oaks Blvd
Ste 130
Trinity, FL 34655
Phone (727) 375-0601

7050 Gall Blvd
Zephyrhills, FL 33541
Phone (813) 779-1209

2600 Bruce B Downs Blvd
Zephyrhills, FL 33544
Phone (954) 393-5000

2801 W Kinnickinnic River Pkwy
Ste 1080
Milwaukee, WI 53215
Phone (414) 908-6506

88948 Box
Milwaukee, WI 53288

3801 Spring St
Mount Pleasant, WI 53405
Phone (262) 636-4011

10180 Washington Ave
Mount Pleasant, WI 53177
Phone (414) 769-4040

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 2

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": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656115200000",
    "number": "1477031557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 322",
            "city": "PORT SANILAC",
            "state": "MI",
            "postal_code": "484690322",
            "telephone_number": "810-300-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 SPRING ST",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "53405",
            "telephone_number": "262-687-4011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2815 S Seacrest Blvd",
            "address_purpose": "LOCATION",
            "city": "Boynton Beach",
            "state": "FL",
            "postal_code": "334357969",
            "country_code": "US",
            "telephone_number": "561-737-7733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GREGORY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-01",
        "last_updated": "2022-06-25",
        "certification_date": "2022-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "243351-30",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11020093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2022; 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.