Individual provider Active NPI

Ryan Johnson

  • Certified Registered Nurse Anesthetist
  • Marquette, MI
National Provider Identifier
1962122986
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704327275 Issued in MI
Practice address
412 High St Apt 3
Marquette, MI 49855-3876
Phone
(517) 294-5788
NPI assigned
Aug 30, 2022
Last updated
Sep 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704327275 MI Primary
Registered Nurse 163W00000X 4704327275 MI

Addresses

Primary practice location

412 High St Apt 3
Marquette, MI 49855-3876

Mailing address

1778 N Hughes Rd
Howell, MI 48843-9174
Phone (517) 294-5788

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250919003987 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991209041 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Michigan-Alpena PLLCGroup PAC ID 6406260124, 25 clinicians
Aspirus KeweenawGroup PAC ID 8123912011, shared by 7 NPIs, 116 clinicians

Practice addresses (Care Compare)

1721 S Stephenson Ave
Iron Mountain, MI 49801-3637
Phone (906) 774-1313

205 Osceola St
Laurium, MI 49913-2134
Phone (906) 337-3100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Keweenaw CurrentSince Sep 1, 2025 Accepting new patients
Hospitalist Medicine Physicians of Michigan-Alpena PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2026 Accepting new patients
Aspirus Keweenaw Current Accepting new patients
Aspirus Keweenaw CurrentSince Sep 1, 2025 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

205 Osceola St
Laurium, MI 49913
Phone (906) 337-3100

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.

Hospital & facility affiliations 3

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": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1962122986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1778 N HUGHES RD",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488439174",
            "telephone_number": "517-294-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 HIGH ST APT 3",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498553876",
            "telephone_number": "517-294-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-30",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704327275",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704327275",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.