Benjamin Keith Johnson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

57.027787 Issued in OH

Practice address

147 GW Hart St
Sheppard Afb, TX 76311

Phone

(940) 676-6075

NPI assigned

Apr 25, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1477908747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 S. EDWIN C. MOSES BLVD",
            "address_2": "EAST MEDICAL PLAZA, 1ST FLOOR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45417",
            "telephone_number": "937-223-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 GW HART ST",
            "city": "SHEPPARD AFB",
            "state": "TX",
            "postal_code": "76311",
            "telephone_number": "940-676-6075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BENJAMIN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-25",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "57.027787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard M. Hiraki, D.D.S.
• Chau Ngoc Hoang, D.M.D
• Kay Ann Host, OTR
• Lacy Dee Hylton, DMD
• Alhaji M Jalloh
• Jacob Lynn Johnson, DMD
• Larry Steven Johnson, M.S.W., L.C.S.W.
• Richard Lee Johnson, DDS, MD
• Raquel N. Karagines, APRN
• Michelle Rae Kastler, PT

• Psychiatry Physician in Sheppard Afb, TX
• Providers in Sheppard Afb, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.