Individual provider Active NPI

Dennis O Johnston, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Bainbridge Island, WA
National Provider Identifier
1740460914
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP 30005029 Issued in WA
Practice address
350 Grow Ave NW
A-9
Bainbridge Island, WA 98110-1754
Phone
(206) 842-7925
NPI assigned
Nov 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP 30005029 WA Primary

Addresses

Primary practice location

350 Grow Ave NW
A-9
Bainbridge Island, WA 98110-1754

Mailing address

350 Grow Ave NW
A-9
Bainbridge Island, WA 98110-1754
Phone (206) 842-7925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180319001159 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931461597 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP 30005029WAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 27, 2020 Accepting new patients

Locations

1200 Lower Fayetteville Rd
#A
Newnan, GA 30265
Phone (404) 881-1094

21600 Highway 99
Ste 260
Edmonds, WA 98026
Phone (425) 774-2650

11800 NE 128th St
Ste 100
Kirkland, WA 98034
Phone (425) 899-4500

501 N 34th St
Ste 101
Seattle, WA 98103
Phone (206) 838-1777

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1740460914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 GROW AVE NW",
            "address_2": "A-9",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981101754",
            "telephone_number": "206-842-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 GROW AVE NW",
            "address_2": "A-9",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981101754",
            "telephone_number": "206-842-7925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "DENNIS",
        "middle_name": "O",
        "name_prefix": "Mr.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-05",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP 30005029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.