Gary N Johnson, M.D.

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

4094 Issued in ND

Practice address

900 E Broadway Ave
Bismarck, ND 58501-4520

Phone

(701) 530-6500

NPI assigned

Jan 22, 2007

Sex

Male

Sole proprietor

No

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.

• Missouri Basin Anesthesia, PLLC

  • Anesthesiology Physician
  • Bismarck, ND
  • NPI 1952413585

  Anesthesiology

  NPD (past)
• St. Alexius Heart & Lung Clinic, LLC

  • Cardiovascular Disease Physician
  • Bismarck, ND
  • NPI 1194823021

  Anesthesiology

  NPD (past)
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 22, 2016.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1962555847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 997",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585020997",
            "telephone_number": "701-530-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E BROADWAY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014520",
            "telephone_number": "701-530-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GARY",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "ND",
            "license": "4094",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ND",
            "license": "4094",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "ND",
            "license": "4094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00227623",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452790",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra Johnson
• Coltan Johnson, CERTIFIED ORTHOTIST
• Craig A Johnson, MD
• Donna Johnson
• Faye Opal Johnson, ND, LAC
• Hannah Rose Johnson, BCBA
• Jacqueline Marie Johnson
• Jaime Johnson
• Jenna Johnson
• Jennifer M Johnson, PT

• All providers in Bismarck, ND
• Pain Medicine Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.