Individual provider Active NPI

David K Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • Albuquerque, NM
National Provider Identifier
1740674894
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024184236 Issued in VA
Practice address
4520 Montgomery Blvd NE Ste 6
Albuquerque, NM 87109-1291
Phone
(505) 308-3145
Fax
(505) 308-3147
NPI assigned
Mar 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 668015 TX
Certified Registered Nurse Anesthetist 367500000X CRNA-01467 NM
Certified Registered Nurse Anesthetist 367500000X AP128885 TX
Certified Registered Nurse Anesthetist 367500000X 0024184236 VA Primary

Addresses

Primary practice location

4520 Montgomery Blvd NE Ste 6
Albuquerque, NM 87109-1291

Mailing address

4520 Montgomery Blvd NE Ste 6
Albuquerque, NM 87109-1291
Phone (505) 308-3145

Other practice location 1

2604 Saint Michael Dr Ste 301
Texarkana, TX 75503-2378
Phone (903) 614-5122

Other practice location 2

801 West Maple Street
Farmington, NM 87401-1291
Phone (505) 609-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM, VA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20151008002715 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365750494 Reassigns benefits to 1 organization
I20170216002500 NM Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365750494 Reassigns benefits to 3 organizations
I20221204000055 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365750494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Street Anesthesia of New Mexico, LLCGroup PAC ID 3476807538, 228 clinicians

Practice addresses (Care Compare)

601 Dr Martin Luther King Jr Ave NE
Lovelace Medical Center
Albuquerque, NM 87102-3619
Phone (505) 727-8000

801 W Maple St
San Juan Regional Hospitalist
Farmington, NM 87401-5630
Phone (505) 609-6463

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
668015TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Sep 5, 2023 Accepting new patients
American Anesthesiology of Virginia, PC CurrentSince Aug 23, 2022 Accepting new patients
Main Street Anesthesia of New Mexico, LLC CurrentSince Sep 1, 2019 Accepting new patients
San Juan Regional Medical Center Inc CurrentSince May 23, 2024 Accepting new patients
San Juan Regional Medical Center Inc Current Accepting new patients
Christus Trinity Clinic Texas CurrentSince Sep 5, 2023 Accepting new patients
Resource Anesthesiology Associates of NM Inc CurrentSince Feb 6, 2017 Accepting new patients
American Anesthesiology of Virginia PC CurrentSince Aug 23, 2022 Accepting new patients
San Juan Regional Medical Center Inc CurrentSince May 23, 2024 Accepting new patients
Trinity Clinic Past Accepting new patients

Locations

504 Elm St NE
Albuquerque, NM 87102
Phone (505) 724-2000

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

801 W Maple St
Farmington, NM 87401
Phone (505) 325-5011

2450 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-8641

117 E 19th St
Roswell, NM 88201
Phone (505) 727-2000

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

7519 Hospital Dr
Gloucester, VA 23061
Phone (804) 693-8800

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

Organizations & group practices 10

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1740674894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 MONTGOMERY BLVD NE STE 6",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091291",
            "telephone_number": "505-308-3145",
            "fax_number": "505-308-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 MONTGOMERY BLVD NE STE 6",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091291",
            "telephone_number": "505-308-3145",
            "fax_number": "505-308-3147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2604 Saint Michael Dr Ste 301",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "TX",
            "postal_code": "755032378",
            "country_code": "US",
            "telephone_number": "903-614-5122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 West Maple Street",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "874011291",
            "country_code": "US",
            "telephone_number": "505-609-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "668015",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "CRNA-01467",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP128885",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024184236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.