DR. BRAD M JOHNSTON (NPI# 1114971223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114971223 |
| Entity Type | Individual |
| Full Name | DR. BRAD M JOHNSTON |
| Credential | M.D. |
| Practice Address |
3707 New Vision Dr Fort Wayne IN 46895-5602 |
| Mailing Address |
3707 New Vision Dr Fort Wayne IN 46845-1702 |
| Practice Telephone | 2604719466 |
| Practice Fax Number | 2604845919 |
| Mailing Telephone | 2609691124 |
| Mailing Fax Number | 6142101886 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2019-04-05 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
01056073A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200491720 | 05 | |
| IN | ANTHEM | 000000362157 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104004894 | Brad Robert Johnston | Nurse Anesthetist, Certified Registered | 801 E 6th St, Suite 205, Panama City, FL 32401-3661 | 2008-02-05 |
| Street Address |
3707 NEW VISION DR |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46895-5602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902870033 | Jay T Jones | Radiology | 3707 New Vision Dr, Fort Wayne, IN 46845-1702 | 2006-02-15 |
| 1952772782 | Nuvena Vein Center, LLC | Radiology | 3707 New Vision Dr, Fort Wayne, IN 46845-1702 | 2015-10-20 |
| 1417394271 | Tram Nguyen Schroeder | Radiology | 3707 New Vision Dr, Fort Wayne, IN 46845-1702 | 2013-06-03 |
| 1538423843 | Michael Gioia | Internal Medicine | 3707 New Vision Dr, Fort Wayne, IN 46845 | 2012-07-02 |
| 1225260342 | Lokender Bommisetty | Radiology | 3707 New Vision Dr, Fort Wayne, IN 46845-1702 | 2009-08-24 |
| 1639300932 | Mark Kim Kelly | Radiology | 3707 New Vision Dr, Fort Wayne, IN 46845-1702 | 2009-08-04 |
| 1053549956 | Melissa Sue Bosma | Radiology | 3707 New Vision Dr, Fort Wayne, IN 46845-1702 | 2009-06-30 |
| 1588828909 | Jeffrey W Birn | Radiology | 3707 New Vision Dr, Fort Wayne, IN 46845-1702 | 2008-07-15 |
| 1396907952 | Samuel Wayne Steury | Radiology | 3707 New Vision Dr, Fort Wayne, IN 46845-1702 | 2008-06-25 |
| 1386811263 | Andrew William Potter | Radiology | 3707 New Vision Dr, Fort Wayne, IN 46845-1702 | 2008-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023062130 | Gregg R Mattison | Radiology | 3707 New Vision Drive, Fort Wayne, IN 46895-5602 | 2006-05-22 |
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376789420 | Richard Frederick Fox | Radiology | 6226 Devils Hollow Rd., Fort Wayne, IN 46814 | 2008-12-19 |
| 1578607149 | Garland Richard Brown | Radiology | 1007 Three Rivers N, Fort Wayne, IN 46802-1334 | 2007-02-16 |
| 1932205077 | Kavita K Erickson | Radiology | 5001 Us Highway 30 W, Suite D, Fort Wayne, IN 46818-9701 | 2006-09-16 |
| 1033226154 | Alan S. Cooperman | Radiology | 14110 Spring Hollow Rd, Fort Wayne, IN 46814-9767 | 2006-08-24 |
| 1336174598 | Mitchell E F Travis | Radiology | 10517 Maple Springs Cv, Fort Wayne, IN 46845-2132 | 2006-07-12 |
| 1023062130 | Gregg R Mattison | Radiology | 3707 New Vision Drive, Fort Wayne, IN 46895-5602 | 2006-05-22 |
| 1184678278 | Charles Tsai | Radiology | 109 Chestnut Hills Pkwy, Fort Wayne, IN 46814-8924 | 2006-05-22 |
| 1922061613 | Mri Center - Fort Wayne Radiology Inc | Radiology | 2110 Carew St, Fort Wayne, IN 46805-4712 | 2006-04-11 |
| 1861455669 | Open View Mri, LLC | Radiology | 10202 Coldwater Rd, Fort Wayne, IN 46825-2076 | 2006-04-11 |
| 1902870033 | Jay T Jones | Radiology | 3707 New Vision Dr, Fort Wayne, IN 46845-1702 | 2006-02-15 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46895 |
Please comment or provide details below to improve the information on DR. BRAD M JOHNSTON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.