Individual provider Active NPI

Roger Dalton Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • Orangeburg, SC
National Provider Identifier
1871884742
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
17516 Issued in SC
Practice address
3000 Saint Matthews Rd
Orangeburg, SC 29118-1442
Phone
(803) 395-2200
Fax
(803) 395-2304
NPI assigned
Apr 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 100263 SC
Certified Registered Nurse Anesthetist 367500000X 17516 SC Primary

Addresses

Primary practice location

3000 Saint Matthews Rd
Orangeburg, SC 29118-1442

Mailing address

PO Box 1245
Orangeburg, SC 29116-1245
Phone (803) 395-4497

Other practice location 1

2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone (803) 791-2000

Other identifiers 1

IdentifierTypeStateIssuer
GP2825MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rjohnson35884@direct.lexmed.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110701000283 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921286469 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lexington Health IncGroup PAC ID 2567872070, 905 clinicians
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone (803) 791-2350

3000 Saint Matthews Rd
Orangeburg, SC 29118-1442
Phone (803) 395-3400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
68.87
Promoting interoperability
100
Improvement activities
40
Cost
78.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
100263SCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Health Inc Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2021 Accepting new patients
Atlantic Coast Anesthesia Services P.C. Nurse Anesthetist, Certified Registered CurrentSince Feb 3, 2017 Accepting new patients
Lexington Health Inc Current Accepting new patients
Musc Community Physicians CurrentSince Jun 2, 2025 Accepting new patients
Musc Community Physicians CurrentSince Jun 2, 2025 Accepting new patients
Lexington County Health Services District Inc Current Accepting new patients
Lexington Health Inc CurrentSince Feb 1, 2021 Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

7035 Saint Andrews Rd
Columbia, SC 29212
Phone (803) 749-0924

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

811 W Main St
Ste 212
Lexington, SC 29072
Phone (803) 358-6180

811 W Main St
Ste 206
Lexington, SC 29072
Phone (803) 358-6200

811 W Main St
Lexington, SC 29072

1021 Cipriana Dr
Ste 100
Myrtle Beach, SC 29572
Phone (843) 449-7885

3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200

2720 Sunset Blvd
West Columbia, SC 29169
Phone (803) 791-2480

Interoperability endpoints

  • Direct secure messaging: rjohnson35884@direct.lexmed.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1871884742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291161245",
            "telephone_number": "803-395-4497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 SAINT MATTHEWS RD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291181442",
            "telephone_number": "803-395-2200",
            "fax_number": "803-395-2304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2720 Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "West Columbia",
            "state": "SC",
            "postal_code": "291694810",
            "country_code": "US",
            "telephone_number": "803-791-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROGER",
        "middle_name": "DALTON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-27",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "100263",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "17516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2825",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rjohnson35884@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2720 Sunset Blvd",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.