NPIMap

Individual provider Active NPI

Anthony T Johnson, MD

  • Family Medicine Physician
  • Mandan, ND
National Provider Identifier
1912918772
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7321 Issued in ND
Practice address
102 Mandan Ave
Mandan, ND 58554-3771
Phone
(701) 667-5000
Fax
(701) 323-5709
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7321 ND Primary

Addresses

Primary practice location

102 Mandan Ave
Mandan, ND 58554-3771

Mailing address

PO Box 5501
Bismarck, ND 58506-5501
Phone (701) 323-6000

Other identifiers 1

IdentifierTypeStateIssuer
18610MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031210001117 ND Practitioner - Family Practice 1052217932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Dakota School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford BismarckGroup PAC ID 9739098575, 562 clinicians

Practice addresses (Care Compare)

102 Mandan Ave
Mandan, ND 58554-3771
Phone (701) 667-5000

Hospital & facility affiliations

  • Sanford Home Care - HHA Home health agency, Mandan, ND, CCN 357029
  • Sanford Home Care - Hospice Hospice, Mandan, ND, CCN 351504
  • Sanford Medical Center Bismarck Hospital, Bismarck, ND, CCN 350015
  • CHI St Alexius Health Hospital, Bismarck, ND, CCN 350002
  • Jacobson Memorial Hospital Care Center Hospital, Elgin, ND, CCN 351314

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions12
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck CurrentSince Aug 4, 1997 Accepting new patients
Sanford Bismarck Current Accepting new patients
Sanford Bismarck Family Medicine CurrentSince Aug 4, 1997 Accepting new patients
Medcenter One Health Systems DME Current Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

701 E Rosser Ave
Bismarck, ND 58501
Phone (701) 751-6755

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

515 E Broadway Ave
Bismarck, ND 58501
Phone (701) 323-5324

102 Mandan Ave
Mandan, ND 58554
Phone (701) 667-5000

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Good Samaritan Society - Sunset DriveMandan, ND, CCN 355065 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 1, 2022
Dec 1, 2022
Good Samaritan Society - Miller PointeMandan, ND, CCN 355106 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 1, 2022
Dec 1, 2022

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1912918772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5501",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585065501",
            "telephone_number": "701-323-6000",
            "fax_number": "701-323-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MANDAN AVE",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585543771",
            "telephone_number": "701-667-5000",
            "fax_number": "701-323-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANTHONY",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "7321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18610",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandan, ND

Sources for this page

Verify at the official NPI Registry.