Bruce Dewayne Johnson, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD0000040859 Issued in TN

Practice address

142 W 5TH St
Cookeville, TN 38501-1760

Phone

(931) 528-2541

Fax

(530) 243-0445

NPI assigned

May 26, 2006

Last updated

Jul 10, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Loma Linda University School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Anesthesia Associates of Chico

  dba Anesthesia Associates of Chico Medical Group Inc

  • Anesthesiology Physician
  • Chico, CA
  • NPI 1770666034
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cookeville Regional Medical Center

  • General Acute Care Hospital
  • Cookeville, TN
  • NPI 1275531956
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1982650289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1092 SUGARHILL PL",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014538",
            "telephone_number": "931-261-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 W 5TH ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385011760",
            "telephone_number": "931-528-2541",
            "fax_number": "530-243-0445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRUCE",
        "middle_name": "DEWAYNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD0000040859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3338289",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alicia Johnson, LPN
• Amy S. Johnson, M.D.
• Andrew David Johnson, M.D.
• Ben Johnson, DC
• Breanna Johnson
• Dawn Gunter Johnson, A.P.N.
• Jeri Johnson
• Joel F Johnson Jr., MD
• Kayla Leann Johnson, LPN
• Kelly Brooke Johnson

• Specialist in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; 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.

Verify at the official NPI Registry.