Benjamin Keith Johnson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2018031276 Issued in MO

Practice address

1140 W Highway 76
Branson, MO 65616-2238

Phone

(417) 317-5318

NPI assigned

Aug 28, 2018

Last updated

Aug 28, 2018By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1811478688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HORSESHOE AVE APT 1",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657149128",
            "telephone_number": "773-559-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W HIGHWAY 76",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656162238",
            "telephone_number": "417-317-5318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BENJAMIN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-28",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2018031276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spenser Interlicchio
• Henry Irvin, PHARM.D
• Its a Wonderful Life LLC
• James J Cesar DO
• Makayla Job
• Everett G Johnson III, D.C.
• Hannah E. Johnson, M.S. CCC-SLP
• Larry Dean Johnson, PA
• Lisa Johnson, NP
• Susanne K Johnson

• Family Medicine Physician in Branson, MO
• Providers in Branson, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.