Renee Lyn Johnson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MED-PHYS-LIC-76923 Issued in MT

Practice address

401 15TH Ave S Ste 206
Great Falls, MT 59405-4334

Phone

(406) 727-2121

Fax

(406) 452-5397

NPI assigned

Mar 25, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1609018498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 15TH AVE S STE 206",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594054334",
            "telephone_number": "406-727-2121",
            "fax_number": "406-452-5397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 15TH AVE S STE 206",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594054334",
            "telephone_number": "406-727-2121",
            "fax_number": "406-452-5397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 1st Ave N",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "594012510",
            "country_code": "US",
            "telephone_number": "406-454-6973",
            "fax_number": "406-791-9277",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 4th St S",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "594013618",
            "country_code": "US",
            "telephone_number": "406-454-6973",
            "fax_number": "406-791-9277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RENEE",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-25",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "7771250-1250",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MT",
            "license": "MED-PHYS-LIC-76293",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2012-0854",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MT",
            "license": "MED-PHYS-LIC-76923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maddie Johnson, PA-C
• Mark H Johnson, PHD
• Michelle Johnson, LCPC, LPMHC
• Mike A. Johnson, M.D.
• Noah Johnson
• Rennae I Johnson, PH D
• Stacey Lynne Johnson, NP
• Taylor Elaine Johnson, PCLC
• Teresa Anne Johnson
• Tracy Ann Johnson

• Pediatrics Physician in Great Falls, MT
• Providers in Great Falls, MT by specialty
• Pediatrics Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.