Clark Woodrow Johnson, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

7821510-1205 Issued in UT

Practice address

1208 E 3300 S
Salt Lake City, UT 84106-2522

Phone

(801) 290-5320

Fax

(801) 290-5321

NPI assigned

Jan 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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 1

Specialty

Psychiatry

Education

University of Utah School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Utah Behavioral Health ServicesGroup PAC ID 9537483607, 185 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cjohnson677748@direct.med.utah.edu

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.

• University of Utah Behavioral Health Services

  • Psychiatry Physician
  • Salt Lake City, UT
  • NPI 1740688613
  Medicare reassignment Care Compare group NPD
• Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
  • NPI 1477676930
  Medicare reassignment NPD
• Utah Regional Hospitalists LLC

  • Hospitalist Physician
  • Murray, UT
  • NPI 1962821223
  Medicare reassignment NPD
• University of Utah Behavioral Health Services

  • Psychiatry Physician
  • Salt Lake City, UT
  • NPI 1225492358
  NPD
• University of Utah Behavioral Health Services

  • Sports Medicine (Psychiatry & Neurology) Physician
  • Salt Lake City, UT
  • NPI 1740158955
  NPD
• Utah Regional Hospitalists LLC

  • Hospitalist Physician
  • Idaho Falls, ID
  • NPI 1740715507
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1487734976
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1588656870
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1699889576
  Care Compare affiliation

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733616000000",
    "number": "1487706099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 E 3300 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062522",
            "telephone_number": "801-290-5320",
            "fax_number": "801-290-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 E 3300 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062522",
            "telephone_number": "801-290-5320",
            "fax_number": "801-290-5321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 E South Temple Fl 2",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841021507",
            "country_code": "US",
            "telephone_number": "801-350-4715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CLARK",
        "middle_name": "WOODROW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2024-12-08",
        "certification_date": "2024-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "241524",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "7821510-1205",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD 60082250",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD 29092",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cjohnson677748@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Catherine Bogan Johnson, NP
• Chandreyee Claudia Johnson
• Charles Johnson
• Charles Johnson, CSW
• Christopher S Johnson, D.D.S.
• Corinne Johnson, LCSW
• Courtney Jillian Johnson, OTR/L
• Daxton Mark Johnson
• Dylan Johnson
• E Brandon Johnson

• Psychiatry Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Psychiatry Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2024; 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.
• 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.