Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Blake Wilson Johnson, DO

Individual provider Anesthesiology Physician · NPI 1760502991

Blake Wilson Johnson, DO is an Anesthesiology in West Jordan, Utah. Qualified in 2004, 22 years ago. Practices with Kauai Medical Clinic, a 150-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona, Kansas and Utah.

Years since qualifying
22
Licensed in
AZ, KS, UT
In the registry since
2007
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

3580 W 9000 S
West Jordan, UT 84088-8812
Phone: (801) 561-8888
Fax: (480) 507-2971
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2400 S Avenue A, Yuma, AZ 85364-7127 — (928) 344-2000

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 6919190-1240 (UT)
Anesthesiology Physician Taxonomy 207L00000X · Licence 012210 (AZ)
Anesthesiology Physician Taxonomy 207L00000X · Licence 94-06211 TEMPORARY (KS)

Record details

NPI number1760502991
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedMarch 30, 2007
Last updated in NPPESJune 11, 2026
Certification dateJune 11, 2026
Mailing addressPo Box 1847, Gilbert, AZ 85299-1847

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Kauai Medical Clinic — 150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in West Jordan