Individual provider Active NPI

Graham Robert Johnson, M.D.

  • Diagnostic Radiology Physician
  • Indianapolis, IN
National Provider Identifier
1770924656
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01080427A Issued in IN
Practice address
550 University Blvd RM 663
Indianapolis, IN 46202-5149
Phone
(317) 944-1866
NPI assigned
Jul 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11017982A IN
Diagnostic Radiology Physician 2085R0202X 01080427A IN Primary

Addresses

Primary practice location

550 University Blvd RM 663
Indianapolis, IN 46202-5149

Mailing address

3750 W 46TH St
Indianapolis, IN 46228-6798

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20180612001016 IN Practitioner - Diagnostic Radiology 6709185127 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Southern Illinois University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indiana University Radiology Associates IncGroup PAC ID 7315922267, 213 clinicians
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

10212 Lantern Rd
Fishers, IN 46037-9705
Phone (317) 841-5656

11725 N Illinois St
Suite 275
Carmel, IN 46032-4656
Phone (317) 817-1114

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

2401 W University Ave
Muncie, IN 47303-3428
Phone (765) 747-4274

2598 W White River Blvd
The Imaging Center
Muncie, IN 47303-5251
Phone (765) 282-7595

2605 E Creeks Edge Dr
Bloomington, IN 47401-8368
Phone (812) 333-1933

2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9356

416 E Maumee St
Angola, IN 46703-2015
Phone (260) 667-5548

550 N University Blvd Room
Suite 0663
Indianapolis, IN 46202-5149

550 University Blvd
Indianapolis, IN 46202-5149
Phone (317) 948-7569

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11017982AINMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients
Indiana University Radiology Associates, Inc. Diagnostic Radiology CurrentSince Jul 1, 2018 Accepting new patients

Locations

5924 Reliable Pkwy
Chicago, IL 60686

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Ste 200
Indianapolis, IN 46219
Phone (317) 962-4836

550 University Blvd
Rm 663
Indianapolis, IN 46202
Phone (317) 274-1866

1701 Senate Blvd
#C6
Indianapolis, IN 46202
Phone (317) 962-9000

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.

Hospital & facility affiliations 5

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": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1770924656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 W 46TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462286798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 UNIVERSITY BLVD RM 663",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025149",
            "telephone_number": "317-944-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GRAHAM",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-08",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11017982A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01080427A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.