Ian Johnson, DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

OP61190273 Issued in WA

Practice address

374 MDG/SGHC, Unit 5071
Apo Ap 96328-5071
Apo, AP 96328-5071

Phone

(315) 225-7508

NPI assigned

Mar 23, 2020

Last updated

Jul 22, 2026By 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

Enrolled in FL

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 1

Specialty

Anesthesiology

Education

Arizona College of Osteopathic Medicine Mid Western University, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012
  Medicare reassignment Care Compare group NPD
• Destin Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Destin, FL
  • NPI 1891726394

  Anesthesiology

  Medicare reassignment NPD
• Fleming Island Anesthesia LLC

  • Anesthesiology Physician
  • Orange Park, FL
  • NPI 1487945895
  Medicare reassignment NPD

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1730715640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "374 MDG/SGHC, UNIT 5071",
            "address_2": "APO AP 96328-5071",
            "city": "APO",
            "state": "AP",
            "postal_code": "963285071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "MIL",
            "address_1": "374 MDG/SGHC, UNIT 5071",
            "address_2": "APO AP 96328-5071",
            "city": "APO",
            "state": "AP",
            "postal_code": "963285071",
            "telephone_number": "315-225-7508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "IAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "OP61190273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.