Active NPI
Avery Clark Johnson, PHARMD
- Pharmacist
- Lehi, UT
National Provider Identifier
1962001727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 343987-1701
- Practice address
- 198 N 1200 E
Lehi, UT 84043-2294 - Phone
- (801) 653-2709
- Fax
- (801) 653-2706
- NPI assigned
- Oct 22, 2020
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 343987-1701 | UT | Primary |
Addresses
Primary practice location
198 N 1200 E
Lehi, UT 84043-2294
Mailing address
14372 S Peacock Midge Dr
Bluffdale, UT 84065-5620
Phone (801) 718-9255
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 343987-1701 | UT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603324800000",
"number": "1962001727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14372 S PEACOCK MIDGE DR",
"city": "BLUFFDALE",
"state": "UT",
"postal_code": "840655620",
"telephone_number": "801-718-9255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "198 N 1200 E",
"city": "LEHI",
"state": "UT",
"postal_code": "840432294",
"telephone_number": "801-653-2709",
"fax_number": "801-653-2706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "AVERY",
"middle_name": "CLARK",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-22",
"last_updated": "2020-10-22",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "343987-1701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lehi, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.