Individual provider Active NPI

Roy Dean Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • Louisville, CO
National Provider Identifier
1780616169
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
169106 Issued in CO
Practice address
100 Health Park Dr
Louisville, CO 80027-9583
Phone
(303) 422-9438
NPI assigned
Jul 7, 2006
Last updated
Nov 10, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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 169106 CO Primary

Addresses

Primary practice location

100 Health Park Dr
Louisville, CO 80027-9583

Mailing address

PO Box 668
Arvada, CO 80001-0668
Phone (303) 422-9438

Other identifiers 1

IdentifierTypeStateIssuer
82757747MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040819000867 ME Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840263521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Aroostook Medical CenterGroup PAC ID 1153233663, 117 clinicians

Practice addresses (Care Compare)

140 Academy St
Presque Isle, ME 04769-3102

146 Academy St
Presque Isle, ME 04769-3102

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as group
Quality
71.56
Promoting interoperability
96
Improvement activities
40
Cost
76.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
169106COMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
The Aroostook Medical Center CurrentSince May 24, 2020 Accepting new patients
The Aroostook Medical Center Current Accepting new patients
The Aroostook Medical Center CurrentSince May 24, 2020 Accepting new patients

Locations

163 Van Buren Rd
Ste 1
Caribou, ME 04736
Phone (207) 498-1227

140 Academy St
Presque Isle, ME 04769
Phone (207) 768-4000

140 Academy St
#10
Presque Isle, ME 04769
Phone (207) 764-3734

140 Academy St
Ste 10
Presque Isle, ME 04769
Phone (207) 764-3734

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1780616169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 668",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800010668",
            "telephone_number": "303-422-9438",
            "fax_number": "303-422-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HEALTH PARK DR",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800279583",
            "telephone_number": "303-422-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROY",
        "middle_name": "DEAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "169106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82757747",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.