Individual provider Active NPI

John Dallin Johnson, NP

  • Nurse Practitioner
  • Murray, UT
National Provider Identifier
1821878174
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10234808-4405 Issued in UT
Practice address
5169 S Cottonwood St Ste 510
Murray, UT 84107-6767
Phone
(801) 507-3584
NPI assigned
Oct 4, 2023
Last updated
Nov 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10234808-4405 UT Primary
Family Nurse Practitioner 363LF0000X 10234808-4405 UT

Addresses

Primary practice location

5169 S Cottonwood St Ste 510
Murray, UT 84107-6767

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

324 E 10th Ave Ste 100
Salt Lake City, UT 84103-2870
Phone (801) 408-7500

Other practice location 2

6322 S 3000 E
Salt Lake City, UT 84121-6922
Phone (801) 965-3600

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240918003850 UT Practitioner - Nurse Practitioner 5799226676 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Columbia School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Granger Medical Clinic PCGroup PAC ID 3476465691, 192 clinicians
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

2965 W 3500
West Valley City, UT 84119-3602
Phone (801) 965-3600

5121 S Cottonwood St
Murray, UT 84107-5701
Phone (801) 507-7000

5169 S Cottonwood St
Suite 510
Murray, UT 84107-6767
Phone (801) 507-3513

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10234808-4405UTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Oct 6, 2025 Accepting new patients
Ihc Health Services Inc CurrentSince Oct 6, 2025 Accepting new patients
Granger Medical Clinic PC Current Accepting new patients
Granger Medical Specialists LLC CurrentSince Aug 15, 2024 Accepting new patients
Granger Medical Clinic, PC CurrentSince Aug 15, 2024 Accepting new patients
Granger Medical Specialists, LLC CurrentSince Aug 15, 2024 Accepting new patients
Ihc Health Services Inc Nurse Practitioner CurrentSince Oct 6, 2025 Accepting new patients
Granger Medical Clinic PC CurrentSince Aug 15, 2024 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Granger Medical Clinic PC PastSince Aug 18, 2024 Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

12391 S 4000 W
Riverton, UT 84096
Phone (801) 302-1700

5169 S Cottonwood St
Ste 510
Salt Lake City, UT 84107
Phone (801) 507-3584

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

324 Tenth Ave
Ste 100
Slc, UT 84103
Phone (801) 408-5735

5171 S Cottonwood St
South Salt Lake, UT 84107
Phone (801) 507-4000

995 W Levoy Dr
Taylorsville, UT 84123

2965 W 3500 S
West Valley City, UT 84119
Phone (801) 965-3505

3725 W 4100 S
West Valley City, UT 84120
Phone (801) 965-3545

1300 SE Cardinal Ct
Ste 190
Vancouver, WA 98683
Phone (360) 448-4479

Organizations & group practices 10

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 2

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": "1696377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1821878174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5169 S COTTONWOOD ST STE 510",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076767",
            "telephone_number": "801-507-3584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "324 E 10th Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841032870",
            "country_code": "US",
            "telephone_number": "801-408-7500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6322 S 3000 E",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841216922",
            "country_code": "US",
            "telephone_number": "801-965-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOHN",
        "middle_name": "DALLIN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-04",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "10234808-4405",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "10234808-4405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.