Individual provider Active NPI

Craig G. Johnson, MD

  • Clinical Neurophysiology Physician
  • Marietta, GA
National Provider Identifier
1700998911
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
29689 Issued in GA
Practice address
2540 Windy Hill Rd SE
Marietta, GA 30067-8605
Phone
(770) 644-1570
NPI assigned
Sep 1, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X 29689 GA Primary

Addresses

Primary practice location

2540 Windy Hill Rd SE
Marietta, GA 30067-8605

Mailing address

1234 Williamswood Pointe
Decatur, GA 30033-2800
Phone (770) 888-2524

Other practice location 1

1234 Williamswood Pointe
Decatur, GA 30033-2800
Phone (770) 888-2524

Other identifiers 1

IdentifierTypeStateIssuer
00345408CMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cjohnson145040@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031118000984 GA Practitioner - Psychiatry 1951215367 Reassigns benefits to 1 organization
Practice locations: Atlanta, GA
I20221201002821 MT Practitioner - Psychiatry 1951215367 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29689GAMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hilo Benioff Medical Center CurrentSince Apr 19, 2018 Accepting new patients
RCHP Billings - Missoula LLC Current Accepting new patients
Stem Medical Group, PC CurrentSince Jan 7, 2023 Accepting new patients
Hilo Benioff Medical Center CurrentSince Apr 19, 2018 Accepting new patients
RCHP Billings - Missoula LLC CurrentSince Aug 5, 2022 Accepting new patients
Hilo Benioff Medical Center Current Accepting new patients
Surgical Care Specialists Inc Past Accepting new patients
Promedica, Inc. Past Accepting new patients

Locations

501 S Cherry St
Ste 1100
Denver, CO 80246
Phone (404) 227-4864

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

2230 N Reserve St
Ste 402
Missoula, MT 59808
Phone (406) 327-3850

2831 Fort Missoula Rd
Ste 206
Missoula, MT 59804
Phone (406) 327-4351

Interoperability endpoints

  • Direct secure messaging: crjohnso@yourcarecommunity.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/CECJAA

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1700998911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 WILLIAMSWOOD POINTE",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332800",
            "telephone_number": "770-888-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 WINDY HILL RD SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678605",
            "telephone_number": "770-644-1570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1234 Williamswood Pointe",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300332800",
            "country_code": "US",
            "telephone_number": "770-888-2524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CRAIG",
        "middle_name": "G.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "GA",
            "license": "29689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00345408C",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cjohnson145040@directwellstar.org",
            "affiliation": "N",
            "address_1": "2540 Windy Hill Rd SE",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300678605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.