NPIMap

Individual provider Active NPI

Benjamin Daniel Johnson, D.O.

  • Internal Medicine Physician
  • Middlebury, VT
National Provider Identifier
1699111237
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
032.0134101 Issued in VT
Practice address
115 Porter Dr
Middlebury, VT 05753-8629
Phone
(802) 388-4701
NPI assigned
May 21, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A-1997-16 NM
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 032.0134101 VT Primary

Addresses

Primary practice location

115 Porter Dr
Middlebury, VT 05753-8629

Mailing address

115 Porter Dr
Middlebury, VT 05753-8629
Phone (802) 388-4701

Other practice location 1

Corner of Routes N12 & N7
Fort Defiance, AZ 86504
Phone (928) 729-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, VT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161117000469 TX Practitioner - HospitalistPractitioner - Internal Medicine 9032344510 Reassigns benefits to 2 organizations
I20230817003137 VT Practitioner - Internal Medicine 9032344510 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of New England, College of Osteo Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Porter Hospital IncGroup PAC ID 1850365180, shared by 5 NPIs, 116 clinicians

Practice addresses (Care Compare)

115 Porter Dr
Middlebury, VT 05753-8423
Phone (802) 388-4701

82 Catamount Park
Middlebury, VT 05753-1292
Phone (802) 388-7185

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
032.0134101VTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Fort Defiance Indian Hospital Board, Incorporation CurrentSince Nov 25, 2019 Accepting new patients
University of Vermont Medical Center Inc Internal Medicine CurrentSince May 17, 2024 Accepting new patients
The Fort Defiance Indian Hospital Board, Incorporation Current Accepting new patients
Porter Hospital, Inc Internal Medicine CurrentSince Jul 15, 2023 Accepting new patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince May 1, 2017 Accepting new patients
Porter Hospital Inc Current Accepting new patients

Locations

3720 Church Rock St
Gallup, NM 87301
Phone (505) 722-2261

1900 Mark Ave
Gallup, NM 87301
Phone (505) 863-6894

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

306 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 863-5754

61 Court Dr
Brandon, VT 05733
Phone (802) 247-3755

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

104 Porter Dr
Middlebury, VT 05753
Phone (802) 388-5682

115 Porter Dr
Middlebury, VT 05753
Phone (802) 388-4701

82 Catamount Park
Middlebury, VT 05753
Phone (802) 388-7185

Interoperability endpoints

  • Direct secure messaging: bjohnson547804@direct.uvmhealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1699111237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 PORTER DR",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057538629",
            "telephone_number": "802-388-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 PORTER DR",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057538629",
            "telephone_number": "802-388-4701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Corner of Routes N12 & N7",
            "address_purpose": "LOCATION",
            "city": "Fort Defiance",
            "state": "AZ",
            "postal_code": "86504",
            "country_code": "US",
            "telephone_number": "928-729-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BENJAMIN",
        "middle_name": "DANIEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-21",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "A-1997-16",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VT",
            "license": "032.0134101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, VT

Sources for this page

Verify at the official NPI Registry.