Clinton Johnson, D.O.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

11297720-1204 Issued in UT

Practice address

350 S 400 E
Bountiful, UT 84010-4932

Phone

(385) 399-7800

Fax

(385) 399-7799

NPI assigned

May 11, 2015

Last updated

Jun 17, 2019By 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 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  UT

  Medicare reassignment NPD
• NGX Lehi Utah PC

  • Physical Medicine & Rehabilitation Physician
  • Bluffdale, UT
  • NPI 1447976287
  NPD (past)
• Nextpain Medical PA

  dba NextPain Care

  • Pain Medicine Physician
  • Lawrenceville, GA
  • NPI 1295564334
  NPD (past)

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1851779938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8372 S BELLINGHAM DR APT A213",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840702185",
            "telephone_number": "801-309-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S 400 E",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104932",
            "telephone_number": "385-399-7800",
            "fax_number": "385-399-7799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Roanoke Ave",
            "address_purpose": "LOCATION",
            "city": "Riverhead",
            "state": "NY",
            "postal_code": "119012031",
            "country_code": "US",
            "telephone_number": "631-388-6215",
            "fax_number": "631-591-3488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CLINTON",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-11",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "UT",
            "license": "11297720-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John C. Edwards MD Inc.
• Colin Johns-Hegerhorst
• Adam Duane Johnson, APRN
• Anthony David Johnson
• Ava Ellen Johnson
• Hannah Melelani Myers Johnson, MA
• Lily Johnson
• Marty J Johnson, NP-C
• Paul Johnson, M.D.
• Rebekah Dru Johnson, DNP, FNP, RN

• Physical Medicine & Rehabilitation Physician in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Physical Medicine & Rehabilitation Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.