Blake Wilson Johnson, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

6919190-1240 Issued in UT

Practice address

3580 W 9000 S
West Jordan, UT 84088-8812

Phone

(801) 561-8888

Fax

(480) 507-2971

NPI assigned

Mar 30, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT, HI2 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

Specialty

Anesthesiology

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kauai Medical ClinicGroup PAC ID 5092628479, 147 clinicians

Intermountain Anesthesia Consultants LLCGroup PAC ID 6709837370, 5 clinicians

NPH Anesthesia of Utah LLCGroup PAC ID 9537584313, 91 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Cross Hospital-Jordan Valley Hospital, West Jordan, UT, CCN 460051
• Wilcox Memorial Hospital Hospital, Lihue, HI, CCN 120014

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 and National Provider Directory roles.

• NPH Anesthesia of Utah, LLC

  • Anesthesiology Physician
  • Ogden, UT
  • NPI 1366077273
  Medicare reassignment Care Compare group NPD
• Kauai Medical Clinic

  • Multi-Specialty Clinic/Center
  • Lihue, HI
  • NPI 1376596643
  Medicare reassignment Care Compare group NPD
• Intermountain Anesthesia Consultants LLC

  • Anesthesiology Physician
  • West Jordan, UT
  • NPI 1205865029
  Medicare reassignment Care Compare group
• Millcreek Anesthesia PC

  • Anesthesiology Physician
  • Salt Lake City, UT
  • NPI 1306879820
  Medicare reassignment NPD
• South Towne Anesthesia LLC

  • Anesthesiology Physician
  • Draper, UT
  • NPI 1457061533
  Medicare reassignment NPD
• Mountain West Anesthesia LLC

  • Anesthesiology Physician
  • Lehi, UT
  • NPI 1558391763
  Medicare reassignment
• Kauai Medical Clinic

  • Durable Medical Equipment & Medical Supplies
  • Koloa, HI
  • NPI 1871611558
  NPD

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

• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • West Jordan, UT
  • NPI 1801591391
  Care Compare affiliation
• Wilcox Memorial Hospital

  • Rural Acute Care Hospital
  • Lihue, HI
  • NPI 1225113442
  Care Compare affiliation

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1760502991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1847",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852991847",
            "telephone_number": "480-507-2961",
            "fax_number": "480-507-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 W 9000 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840888812",
            "telephone_number": "801-561-8888",
            "fax_number": "480-507-2971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 S Avenue A",
            "address_purpose": "LOCATION",
            "city": "Yuma",
            "state": "AZ",
            "postal_code": "853647127",
            "country_code": "US",
            "telephone_number": "928-344-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BLAKE",
        "middle_name": "WILSON",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "012210",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "6919190-1240",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KS",
            "license": "94-06211 TEMPORARY",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841453362",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Virginia Jimenez, BCBA
• R Ryan Johansen, D.D.S.
• Richard Bart Johansen, MD
• Richard Eric Johansen, DDS
• John R. Ayre, Jr. DDS PC
• Brian Lafe Johnson, DMD
• Dana L Johnson
• Daniel Thomas Johnson, D.V.M.
• Heather Johnson, DPT
• Jack Johnson

• Anesthesiology Physician in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Anesthesiology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.