Kent G Johnson, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

171184-1205 Issued in UT

Practice address

3838 S 700 E
Suite 200
Salt Lake City, UT 84106-1466

Phone

(801) 261-4988

Fax

(801) 269-9427

NPI assigned

Sep 7, 2005

Last updated

May 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lifetree Medical Inc

  • Pain Medicine Physician
  • Salt Lake City, UT
  • NPI 1447250147

  Anesthesiology

  NPD (past)
• Omega Interventional Pain PLLC

  • Pain Medicine Physician
  • Salt Lake City, UT
  • NPI 1417253907
  NPD (past)

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1639163413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27688",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270688",
            "telephone_number": "801-534-1360",
            "fax_number": "801-366-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 S 700 E",
            "address_2": "SUITE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061466",
            "telephone_number": "801-261-4988",
            "fax_number": "801-269-9427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KENT",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "171184-1205",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "70294",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07727",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kate Johnson, LCSW
• Kate Johnson, MFT
• Kathryn Johnson, AUD
• Kelly Brooke Johnson
• Kenneth Johnson I
• Kent N Johnson, D.M.D.
• Kenward Borg Johnson, MD
• Kevin Herbert Johnson, CPSSS
• Kimberly Johnson
• Kira D Johnson, PA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.