Individual provider Active NPI

Wayne Thomas Johnson, D.C.

  • Sports Physician Chiropractor
  • Layton, UT
National Provider Identifier
1558342105
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
95-288007-1202 Issued in UT
Practice address
70 S Fairfield Rd
Suite 7
Layton, UT 84041-5111
Phone
(801) 444-1002
Fax
(801) 444-0170
NPI assigned
Nov 10, 2005
Last updated
Jun 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 95-288007-1202 UT Primary

Addresses

Primary practice location

70 S Fairfield Rd
Suite 7
Layton, UT 84041-5111

Mailing address

70 S Fairfield Rd
Suite 7
Layton, UT 84041-5111
Phone (801) 444-1002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080715000161 UT Practitioner - Chiropractic 2860565538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

471 Heritage Park Blvd
Suite 3
Layton, UT 84041-5623
Phone (801) 444-1002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95-288007-1202UTMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson Chiropractic Inc CurrentSince Feb 1, 2008 Accepting new patients

Locations

471 Heritage Park Blvd
Ste 3
Layton, UT 84041
Phone (801) 444-1002

70 S Fairfield Rd
Ste 7
Layton, UT 84041
Phone (801) 444-1002

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1558342105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 S FAIRFIELD RD",
            "address_2": "SUITE 7",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415111",
            "telephone_number": "801-444-1002",
            "fax_number": "801-444-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 S FAIRFIELD RD",
            "address_2": "SUITE 7",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415111",
            "telephone_number": "801-444-1002",
            "fax_number": "801-444-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "WAYNE",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "UT",
            "license": "95-288007-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.