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

Dr. Jesse Clark Johnson, MD

Individual provider Diagnostic Radiology Physician · NPI 1033146212

Dr. Jesse Clark Johnson, MD is a Diagnostic Radiology in Traverse City, Michigan. Graduated from University of Arizona College of Medicine in 2001, 25 years ago. Practices with Grand Traverse Radiologists PC, a 32-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
25
Trained at
University of Arizona College of Medicine
Licensed in
MI
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1105 Sixth St
Traverse City, MI 49684-2345
Phone: (231) 935-0497
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 4301078527 (MI)

Record details

NPI number1033146212
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 26, 2006
Last updated in NPPESApril 29, 2020
Certification dateApril 29, 2020
Mailing addressPo Box 30516, Dept. 9516, Lansing, MI 48909

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolUNIVERSITY OF ARIZONA COLLEGE OF MEDICINE
Graduated 2001 (25 years in practice)
Group practice Grand Traverse Radiologists Pc — 32 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Traverse City