BRENT E JOHNSON (NPI# 1487640447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487640447 |
| Entity Type | Individual |
| Full Name | BRENT E JOHNSON |
| Credential | M.D. |
| Practice Address |
1000 Ainsworth Dr Suite 115 Prescott AZ 86305-1667 |
| Practice Telephone | 9287781971 |
| Practice Fax Number | 9284438473 |
| Mailing Telephone | 9287781971 |
| Mailing Fax Number | 9284438473 |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2011-07-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 20366 | AZ | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 069709 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861985574 | Brent David Johnson | Dentist | 70 Westridge Pkwy Ste 200, Mcdonough, GA 30253-3048 | 2018-06-08 |
| 1306233283 | Brent Johnson | Contractor | 404 Cayland Ct, Chesapeake, VA 23322-3624 | 2015-04-18 |
| 1558760835 | Brent Johnson | Physical Therapist | 1260 State Hwy 25, Monticello, MN 55362-8447 | 2014-08-22 |
| 1710021670 | Brent Johnson | Dentist | 6351 Preston Rd, Suite 301, Frisco, TX 75034-5805 | 2007-02-16 |
| 1710031463 | Brent Warren Johnson | Optometrist | 700 Se Chkalov Dr, Suite 5, Vancouver, WA 98683-5202 | 2007-01-22 |
| 1790708857 | Brent David Johnson | Dentist | 3901 Pine Lake Rd Ste 250, Lincoln, NE 68516-5497 | 2006-07-26 |
| 1093715013 | Brent M Johnson | Physician Assistant | 5656 W Us Highway 10, Ludington, MI 49431-2454 | 2005-08-01 |
| 1205309309 | Brent H Johnson | Registered Nurse | 509 Biltmore Ave, Asheville, NC 28801-4601 | 2019-01-10 |
| 1659859270 | Brent D Johnson | Physical Therapist | 103 Whitewater Pl Ste D, Polson, MT 59860-4502 | 2018-08-06 |
| 1982028163 | Brent Johnson | Social Worker | 1918 N Main St, Findlay, OH 45840-3818 | 2014-02-10 |
| Street Address |
1000 AINSWORTH DR SUITE 115 |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86305-1667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265428254 | Brian D Kimball | Specialist | 1000 Ainsworth Dr, Suite 115, Prescott, AZ 86305-1667 | 2005-09-23 |
| 1679505812 | Michele M Peters Fnp | Clinic/Center | 1000 Ainsworth Dr, Ste A220, Prescott, AZ 86305-1645 | 2006-07-07 |
| 1750377610 | Robert T Barry | Specialist | 1000 Ainsworth Dr, Suite 115, Prescott, AZ 86305-1667 | 2005-09-26 |
| 1669468526 | Michael J D'angelo | Specialist | 1000 Ainsworth Dr, Suite 115, Prescott, AZ 86305-1667 | 2005-09-26 |
| 1396731352 | Warren G Goodman | Specialist | 1000 Ainsworth Dr, Suite 115, Prescott, AZ 86305-1667 | 2005-09-26 |
| 1003802968 | Stanley R Smith | Specialist | 1000 Ainsworth Dr, Suite 115, Prescott, AZ 86305-1667 | 2005-09-26 |
| 1528054517 | David R Amstutz | Specialist | 1000 Ainsworth Dr, Suite 115, Prescott, AZ 86305-1667 | 2005-09-23 |
| 1164418158 | Matthew R Dicker | Specialist | 1000 Ainsworth Dr, Suite 115, Prescott, AZ 86305-1667 | 2005-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972005395 | Granite View Adult Care Home LLC | Assisted Living Facility | 7105 Williamson Valley Road, Prescott, AZ 86305 | 2018-03-01 |
| 1215468095 | Valerie Williams | Occupational Therapist | 926 S. Hinman Dr., Prescott, AZ 86305 | 2017-03-23 |
| 1174073837 | Caspian Gleam Medical Center LLC | Clinic/Center | 3130 Stillwater Drive, Suite B, Prescott, AZ 86305 | 2016-10-06 |
| 1114388634 | Marla Beth Perkins | Speech-Language Pathologist | 3160 Stillwater Dr., Prescott, AZ 86305 | 2016-03-10 |
| 1790159853 | Michele A. Bibeau, D.d.s. | Dentist | 1058 Fair Street, Suite A, Prescott, AZ 86305 | 2015-11-30 |
| 1609264837 | Integrative Pain Centres of Prescott | Pain Medicine | 3769 Crossings Drive, Suite B, Integrative Pain Centres of Prescott, Prescott, AZ 86305 | 2014-12-22 |
| 1649697251 | Sharon Marilyn Jackson | Counselor | 3636 Crossings Drive, Prescott, AZ 86305 | 2014-03-20 |
| 1215351259 | Stefanie Maneval | Registered Nurse | 900 Iron Springs Rd, Prescott, AZ 86305 | 2014-02-11 |
| 1508207523 | Recovery In The Pines, LLC | Community/Behavioral Health | 919 12th Place #13, Prescott, AZ 86305 | 2013-07-08 |
| 1871857359 | Neal Herbert Segovia Cabaluna | Internal Medicine | 3773 Crossings Dr Ste C, Prescott, AZ 86305 | 2012-06-28 |
| Find all providers in zip 86305 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255721684 | Ronald Lake II | Specialist | 807 Lizzard Ln, Prescott, AZ 86303-4517 | 2015-01-22 |
| 1962808220 | Karie Mangiardi-hammond | Specialist | 3160 Stillwater Dr, Prescott, AZ 86305-7151 | 2014-11-14 |
| 1649610999 | Cheryl A Rynd | Specialist | 1745 Rustic Timbers Ln, Suite D, Prescott, AZ 86303-4966 | 2013-07-01 |
| 1629416755 | Irene A. Hsieh | Specialist | 1820 Sequoia Dr, Prescott, AZ 86301-1245 | 2013-06-11 |
| 1235416918 | Gregg P Standage Md | Specialist | 705 W Hillside Ave, Prescott, AZ 86301-1938 | 2011-11-09 |
| 1467694901 | Kim Suzanne Plawchan | Specialist | 522 E. Sheldon St, Prescott, AZ 86301 | 2009-03-30 |
| 1699920207 | Mark Edwin Carli | Specialist | 3108 Clearwater Dr Ste B2, Prescott, AZ 86305-7170 | 2008-11-24 |
| 1922270438 | Karen L Yates Md PC | Specialist | 141 S Mccormick St Ste 108, Prescott, AZ 86303-4730 | 2008-03-25 |
| 1982880142 | Kathleen F Parker | Specialist | 4864 E Diamond Dr, Prescott, AZ 86301-5944 | 2008-01-17 |
| 1548469372 | Ben Eugene Paxton | Specialist | 1000 Ainsworth # 115, Prescott, AZ 86305 | 2007-07-12 |
| Find all providers in PRESCOTT | ||||
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| 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.