| Bradley Todd Johnson, | |
|
1010 Three Springs Blvd, Durango, CO 81301-8296 | |
| (303) 306-7783 | |
| (303) 306-7753 |
| Full Name | Bradley Todd Johnson |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 30 Years |
| Location | 1010 Three Springs Blvd, Durango, Colorado |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710167655 | NPI | - | NPPES |
| 35323884 | Medicaid | NM | |
| 48483885 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 956 (Wisconsin) | Secondary |
| 363A00000X | Physician Assistant | 3202 (Colorado) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Stoughton Hospital | Stoughton, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Edgerton Hospital And Health Services, Inc | 7719874502 | 40 |
| Stoughton Hospital Association | 7012825706 | 66 |
| Entity Name | Edgerton Hospital and Health Services, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154350049 PECOS PAC ID: 7719874502 Enrollment ID: O20040304000743 |
| Entity Name | Stoughton Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679558647 PECOS PAC ID: 7012825706 Enrollment ID: O20040402001358 |
| Entity Name | Southern Wisconsin Emergency Associates SC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568538189 PECOS PAC ID: 3274561055 Enrollment ID: O20050802000934 |
| Entity Name | Stoughton Hospital Association |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1679558647 PECOS PAC ID: 7012825706 Enrollment ID: O20100106000471 |
| Entity Name | Edgerton Hospital and Health Services, Inc |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1154350049 PECOS PAC ID: 7719874502 Enrollment ID: O20110318000342 |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley Todd Johnson, Po Box 17752, Denver, CO 80217-0752 Ph: (303) 306-7783 | Bradley Todd Johnson, 1010 Three Springs Blvd, Durango, CO 81301-8296 Ph: (303) 306-7783 |
Michelle Ann Archer, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 575 Rivergate Ln Unit 105, Durango, CO 81301 Phone: 970-259-3020 |
Christopher A Stewart, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2577 Main Ave, Durango, CO 81301 Phone: 970-247-8382 Fax: 970-259-4403 |
Peter E Jamieson, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1 Mercado St, Suite 202, Durango, CO 81301 Phone: 970-247-5362 Fax: 970-259-6045 |
Mr. Benjamin Donald Reetz, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2577 Main Ave, Durango, CO 81301 Phone: 970-247-8382 |
Lexi Kathryn Querio, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 810 E 3rd St, Suite 201, Durango, CO 81301 Phone: 970-764-1790 Fax: 970-375-7927 |
Natalie Stilwell, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 575 Rivergate Ln Unit 205, Durango, CO 81301 Phone: 970-259-5990 |
Jessica Harrison, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1201 Main Ave, Suite 203, Durango, CO 81301 Phone: 970-403-0555 Fax: 970-403-0556 |