Courtney R Johnson, MD

Primary specialty

Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X

License

19112 Issued in AZ

Practice address

1432 S Dobson Rd
Suite 501
Mesa, AZ 85202-4768

Phone

(480) 412-7457

Fax

(480) 412-7475

NPI assigned

Jul 21, 2006

Last updated

Mar 17, 2016By 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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1902827694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1432 S DOBSON RD",
            "address_2": "SUITE 501",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024768",
            "telephone_number": "480-412-7457",
            "fax_number": "480-412-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 S DOBSON RD",
            "address_2": "SUITE 501",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024768",
            "telephone_number": "480-412-7457",
            "fax_number": "480-412-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "COURTNEY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "2000213",
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "AZ",
            "license": "19112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L3714",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "289703",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116055900",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brayden Daniel Johnson
• Brittany Johnson
• Carl M Johnson, TRPC, CPSS, BHT
• Carlie Lynn Johnson
• Christy Johnson, LAC
• Danielle Johnson, PT
• Darnell K Johnson
• David Curtis Johnson, MD
• Devon Max Johnson, NCC, LPC
• Edward E. Johnson, PA

• Pediatric Rheumatology Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Pediatric Rheumatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; 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.