Active NPI
Ryan Michael Johnson, D.O.
- Neurological Surgery Physician
- Normal, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 125069500
- Practice address
- 1300 Franklin Ave Ste 110
Normal, IL 61761-3799 - Phone
- (309) 268-3502
- NPI assigned
- Jun 17, 2016
- Last updated
- Jun 17, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 125069500 | IL | Primary |
Addresses
Primary practice location
1300 Franklin Ave Ste 110
Normal, IL 61761-3799
Mailing address
2000 N Linden St Apt C305
Normal, IL 61761-5337
Phone (740) 632-3117
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurosurgery
- Education
- University of Pikeville, Kentucky College of Osteopathic Med, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
610 N Lincoln Ave
Urbana, IL 61801-2432
Phone (217) 383-6555
611 W Park St
Urbana, IL 61801-2500
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 63 |
| Laminectomy or laminotomy (partial removal of spine bones) | 68 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carle Health Medical Group | Current | Accepting new patients | |
| Carle West Physician Group Inc | Current | Accepting new patients | |
| Carle Health Care Incorporated | Past | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461
3310 Fields South Dr
Champaign, IL 61822
Phone (217) 902-5300
1300 Franklin Ave
Ste 110
Normal, IL 61761
Phone (309) 268-3502
1302 Franklin Ave
Ste 2800
Normal, IL 61761
Phone (309) 268-6300
610 N Lincoln Ave
Urbana, IL 61801
Phone (217) 383-3507
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Interoperability endpoints
- rjohnsondo319163@carlehiedirect.net
Organizations & group practices 4
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.
-
dba Carle Physician Group
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
-
- Family Medicine Physician
- Normal, IL
- NPI 1467074138
-
- Durable Medical Equipment & Medical Supplies
- Champaign, IL
- NPI 1114240876
-
dba Gibson Area Hospital and Health Services
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Mattoon, IL
- NPI 1669564662
-
- General Acute Care Hospital
- Urbana, IL
- NPI 1013071653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466121600000",
"number": "1932559119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 N LINDEN ST APT C305",
"city": "NORMAL",
"state": "IL",
"postal_code": "617615337",
"telephone_number": "740-632-3117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 FRANKLIN AVE STE 110",
"city": "NORMAL",
"state": "IL",
"postal_code": "617613799",
"telephone_number": "309-268-3502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "RYAN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-17",
"last_updated": "2016-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "IL",
"license": "125069500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Normal, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; 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.
- 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.