Brent E Johnson, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

20366 Issued in AZ

Practice address

1000 Ainsworth Dr
Suite 115
Prescott, AZ 86305-1667

Phone

(928) 778-1971

Fax

(928) 443-8473

NPI assigned

Sep 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311552000000",
    "number": "1487640447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 AINSWORTH DR",
            "address_2": "SUITE 115",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051667",
            "telephone_number": "928-778-1971",
            "fax_number": "928-443-8473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 AINSWORTH DR",
            "address_2": "SUITE 115",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051667",
            "telephone_number": "928-778-1971",
            "fax_number": "928-443-8473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRENT",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2011-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "20366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069709",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John F Mackenzie DO PC
• John P Passamani MD PA
• John R Markham PC
• John R. Markham PC
• Christopher Aaron Johns, M.D.
• Charles H Johnson, M.D.
• Jacqueline J Johnson, LPC
• Karen Marie Johnson, MD
• Lindsey Allyson Johnson, FNP-C
• Rachel Johnson

• Specialist in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2011; 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.