Brent Mitchell Johnson, M.D.

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

0101043592 Issued in VA

Practice address

2331 Franklin Rd SW
Roanoke, VA 24014-1111

Phone

(540) 725-1226

Fax

(540) 857-5306

NPI assigned

Dec 28, 2005

Last updated

Mar 29, 2016By 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

Other identifiers 20

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

Interoperability endpoints

• Direct secure messaging: bjohnson5973@direct.carilionclinic.org

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.

• Roanoke Orthopaedic Center, Inc.

  dba Roanoke Orthopaedic Center

  • Orthopaedic Surgery Physician
  • Roanoke, VA
  • NPI 1821021858
  NPD (past)

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1679550933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141111",
            "telephone_number": "540-725-1226",
            "fax_number": "540-857-5306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141111",
            "telephone_number": "540-725-1226",
            "fax_number": "540-857-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRENT",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "VA",
            "license": "0101043592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA PREMIER",
            "identifier": "1679550933",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1679550933",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH/CARENET/CARELINK/COVENTRY",
            "identifier": "1679550933",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679550933",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1679550933",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHKEEPERS",
            "identifier": "1679550933",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1679550933",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "371194700",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1679550933",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA HEALTH PLAN",
            "identifier": "1679550933",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1679550933",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID OF NORTH CAROLINA",
            "identifier": "1679550933",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHKEEPERS PLUS",
            "identifier": "1679550933",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1679550933",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA HEALTH NETWORK",
            "identifier": "1679550933",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/CHAMPUS",
            "identifier": "540506332005",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID OF WEST VIRGINIA",
            "identifier": "3810018723",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00831109",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA MEDICARE",
            "identifier": "1679550933",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTOTAL",
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    ],
    "endpoints": [],
    "other_names": []
}

• David E Johnsen, M.D.
• Johnson Curran Optometry Centers PC
• Camron L Johnson Privitera, D.O.
• Sandra Ellen Johnson-Harris, L.C.S.W.
• Anthony Tyler Johnson
• Bruce E Johnson, MD
• Crystal G Johnson, SLP
• Dana S Johnson, RMA/CAREGIVER
• Danielle Johnson, LCSW
• Emily Brooke Johnson, PHARMD

• Sports Medicine (Orthopaedic Surgery) Physician in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.