Individual provider Active NPI

Perry S Johnson, DC

  • Chiropractor
  • Bluffton, IN
National Provider Identifier
1831196310
Registry record updated Dec 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
080001137 Issued in IN
Practice address
715 N Main St
Bluffton, IN 46714-1313
Phone
(260) 824-8183
Fax
(260) 824-8184
NPI assigned
Jun 30, 2005
Last updated
Dec 21, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 080001137 IN Primary

Addresses

Primary practice location

715 N Main St
Bluffton, IN 46714-1313

Mailing address

1085B N Main St
Bluffton, IN 46714-1322
Phone (260) 824-8183

Other identifiers 3

IdentifierTypeStateIssuer
000000356189OtherINANTHEM
P00182728OtherINMEDICARE RR
100386440AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050204000462 IN Practitioner - Chiropractic 2264483460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

715 N Main St
Bluffton, IN 46714-1313
Phone (260) 824-8183

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
080001137INMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
P Scott Johnson D C Inc Chiropractor CurrentSince Jan 1, 2004 Accepting new patients

Locations

1085 N Main St
#B
Bluffton, IN 46714
Phone (219) 824-8183

715 N Main St
Bluffton, IN 46714
Phone (260) 307-6053

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513814400000",
    "number": "1831196310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085B N MAIN ST",
            "city": "BLUFFTON",
            "state": "IN",
            "postal_code": "467141322",
            "telephone_number": "260-824-8183",
            "fax_number": "260-824-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N MAIN ST",
            "city": "BLUFFTON",
            "state": "IN",
            "postal_code": "467141313",
            "telephone_number": "260-824-8183",
            "fax_number": "260-824-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PERRY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2017-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "080001137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000356189",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00182728",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100386440A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; 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.