Brad Dale Johnson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

E-1424 Issued in AR

Practice address

2710 Rife Medical LN
Rogers, AR 72758-1452

Phone

(479) 338-0200

Fax

(479) 338-3388

NPI assigned

Jan 11, 2007

Last updated

Oct 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sgoh Acquisition Inc

  dba Ozarks Community Hospital of Gravette

  • Critical Access Hospital
  • Gravette, AR
  • NPI 1568643005
  Medicare reassignment NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  AR

  Medicare reassignment NPD
• Sgoh Acquisition Inc

  dba Och Decatur Clinic

  • Rural Health Clinic/Center
  • Decatur, AR
  • NPI 1699513507
  NPD
• Benton Emergency Group LLC

  • Emergency Medicine Physician
  • Bentonville, AR
  • NPI 1720187214
  NPD (past)
• Bentonville Radiology Consultants, PLLC

  • Diagnostic Radiology Physician
  • Bentonville, AR
  • NPI 1003882747
  NPD (past)
• Mercy Health Northwest Arkansas Communities

  • Multi-Specialty Clinic/Center
  • Rogers, AR
  • NPI 1265490916
  NPD (past)
• QHG of Springdale Inc

  dba Northwest Medical Center of Washington County

  • Neonatal-Perinatal Medicine Physician
  • Springdale, AR
  • NPI 1730292434
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1780734830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 RIFE MEDICAL LN",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-338-0200",
            "fax_number": "479-338-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 RIFE MEDICAL LN",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-338-0200",
            "fax_number": "479-338-3388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Jackson St SW",
            "address_purpose": "LOCATION",
            "city": "Gravette",
            "state": "AR",
            "postal_code": "727369121",
            "country_code": "US",
            "telephone_number": "479-787-5291",
            "fax_number": "479-344-6404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRAD",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-1424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135003001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joe Hines Chiropractic, Inc. (Hines Chiropractic & Rehabilitation Clinic)
• John a Huskins MD LLC
• Abbey Johnson
• Amanda Leigh Johnson, RN
• Andrew C Johnson, DDS, MDS, CDT
• Christopher S Johnson, MD
• Donna Dee Johnson, MD
• Felicity Johnson, MS, LPC
• Kearsten Nicole Johnson
• Leola Johnson, MS, CCC-SLP

• Emergency Medicine Physician in Rogers, AR
• Providers in Rogers, AR by specialty
• Emergency Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.