MR. TIMOTHY BART JOHNSON (CRNA) – Certified Registered Nurse Anesthetist, NPI 1588764583

MR. TIMOTHY BART JOHNSON (CRNA) is a healthcare provider. based in Broken bow, Nebraska. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 100588 (NE). The NPI Number for MR. TIMOTHY BART JOHNSON (CRNA) is 1588764583

Main info

Male
Sole Proprietor
31 Years Of Experience
Name
MR. TIMOTHY BART JOHNSON (CRNA)
NPI
1588764583
Phone
(308) 872-2294
Address
79568 SUMNER ROAD
Enumeration Date
22 September 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Secondary Phone
3088724100
Graduation Year
1995 (31 years ago)
PAC ID
8729061965
Group Practice PAC ID
5799766440
Professional Enrollment ID
I20040609001257
Address ID
NE688221378BR145XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

534 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in NE

Provider Addresses for MR. TIMOTHY BART JOHNSON (CRNA)

  • 79568 SUMNER ROAD

    BROKEN BOW, NE 68822

    Phone: (308) 872-2294

    Fax: (308) 872-6272

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-06-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040609001257ICertified Registered Nurse Anesthetist (Crna)NETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 68822)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5799766440View full group profile
NameSpecialtyState
Family Practice, Emergency MedicineNE
Family Practice, Emergency MedicineNE
Family PracticeNE
Family PracticeNE
Family PracticeIA

Reviews

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Frequently asked questions

Does MR. TIMOTHY BART JOHNSON (CRNA) have a public NPI I can cite?
Public records show MR. TIMOTHY BART JOHNSON (CRNA) under NPI 1588764583.
Is MR. TIMOTHY BART JOHNSON (CRNA) currently accepting referrals based on NPI status?
Registry metadata lists MR. TIMOTHY BART JOHNSON (CRNA) as active.
What does the directory say MR. TIMOTHY BART JOHNSON (CRNA) does?
Insurance directories may phrase it differently, but here MR. TIMOTHY BART JOHNSON (CRNA) maps to Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to MR. TIMOTHY BART JOHNSON (CRNA)?
MR. TIMOTHY BART JOHNSON (CRNA) is associated with Broken Bow, Nebraska in the same public data insurers reference.
Can I export MR. TIMOTHY BART JOHNSON (CRNA)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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