Corey B Johnson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1848241205 Issued in UT

Practice address

1219 N 400 E
Logan, UT 84341-2321

Phone

(435) 753-2842

NPI assigned

Aug 11, 2006

Last updated

Jul 8, 2007By 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 1

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

• Corey B Johnson MD PC

  dba cache vein care

  • Family Medicine Physician
  • Logan, UT
  • NPI 1114115763
  Authorized official Same address or phone
• Alaska Vein Care LLC

  • Phlebology Physician
  • Wasilla, AK
  • NPI 1538487905
  NPD (past)
• Rosebud Indian Health Service

  • Ambulatory Surgical Clinic/Center
  • Rosebud, SD
  • NPI 1790955128
  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639180698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 S 200 W",
            "city": "HYRUM",
            "state": "UT",
            "postal_code": "843191241",
            "telephone_number": "435-245-3348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 N 400 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412321",
            "telephone_number": "435-753-2842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "COREY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "1848241205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard John, DO
• Bruce R. Johns, PHD
• Andrea Cara Johnson
• Aubrey Johnson, PMHNP-BC
• Clark Johnson
• Donna Johnson, ACMHC
• Kyle Cameron Johnson, DPT
• M. Andrew Johnson, DDS
• Marianne Johnson
• McKinsey Johnson

• Family Medicine Physician in Logan, UT
• Providers in Logan, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.