Active NPI
Gregory Wallace Johnson, RT
- Diagnostic Radiology Physician
- Woods Cross, UT
National Provider Identifier
1558877134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 380908-5401
- Practice address
- 769 W 1900 S
Woods Cross, UT 84087-1720 - Phone
- (801) 706-8132
- NPI assigned
- Dec 19, 2017
- Last updated
- Dec 19, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 380908-5401 | UT | Primary |
Addresses
Primary practice location
769 W 1900 S
Woods Cross, UT 84087-1720
Mailing address
769 W 1900 S
Woods Cross, UT 84087-1720
Phone (801) 706-8132
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 380908-5401 | UT | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513641600000",
"number": "1558877134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "769 W 1900 S",
"city": "WOODS CROSS",
"state": "UT",
"postal_code": "840871720",
"telephone_number": "801-706-8132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "769 W 1900 S",
"city": "WOODS CROSS",
"state": "UT",
"postal_code": "840871720",
"telephone_number": "801-706-8132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "GREGORY",
"middle_name": "WALLACE",
"credential": "RT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-12-19",
"last_updated": "2017-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "UT",
"license": "380908-5401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woods Cross, UT
- Ihc Health Services Inc (Intermountain Health Home Medical Equipment Bountiful)
- Independence Home Care, LLC (Independence Home Health)
- Interpath, P.C.
- Ryan Larry Jeffs, MS LMFT
- Jenna Shirley Counseling
- Jason Alan Johnson, M.D.
- Kimberly Scarlet Jones, C-SUD-C
- Lachelle Richardson Jones, LCSW
- Allison Christa Klepzig, LCSW
- Rebecca W Kohler, MSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.