ADAM JOHNSON

NPI 1750150033 · Physical Therapist · Anthem

Provider Status Assessment

Needs Review

Carrier listings present but Colorado DORA license appears expired or revoked.

Confidence: High

Evidence: 9647 items from 13 sources

Signals: 4 supporting · 1 opposing · 2 missing

Resolution: Carrier listings present but Colorado DORA license appears expired or revoked. Licensure concern outweighs network presence.

Data Source Signals

✓

NPPES

WESTMINSTER, 80003

Freshness: Unknown

✓

Network Status

Listed with 10 carriers

anthem_co — in_network (commercial)
anthem_co — in_network (commercial)
uhc_colorado_co — in_network (commercial)
uhc_insurance_co — in_network (commercial)
uhc_services_co — in_network (commercial)
uhc_umr_co — in_network (commercial)
uhc_surest_co — in_network (commercial)
kpic_co — in_network (commercial)
aetna_co — in_network (commercial)
kaiser_co — in_network (commercial)

✗

DORA License

Expired

—

Medicare

Non-Medicare specialty

✗

Care Compare

Address mismatch with NPPES

GOLDEN, 80401
WESTMINSTER, 80003

—

PECOS Enrollment

System Reasoning

Claim Under Evaluation

Provider is actively practicing and appropriately listed in carrier networks

Evidence Evaluated

Colorado DORA License: License status: Expired

FHIR Directory: No active FHIR endpoint despite carrier listings

NPPES Registry: Active NPI, registered in WESTMINSTER

Federal Exclusion Check: No federal exclusions found (OIG LEIE, SAM.gov)

Carrier Networks: Listed in 10 carrier networks

CMS Care Compare: Found in Care Compare with 2 locations

Medicare Billing: No Medicare billing records available

PECOS Enrollment: PECOS enrollment status unknown

Trust Evaluation

identity:0.75Strong

licensure:0.20Critical

activity:

Dimension Scores

Composite0.66

Identity0.75 — Moderate

Active NPI with specialty classification

Licensure0.20 — Critical

DORA license expired or revoked

Activity0.75 — Moderate

No Medicare billing · No electronic endpoint · No PECOS enrollment

Reachability0.60 — Moderate

Single address source (NPPES)

Network1.00 — Strong

Listed in multiple carrier networks

Why is this provider classified as “needs review”?

Evidence across dimensions is contradictory or specific concerns exist (unverified license, FHIR directory contradiction). Manual review recommended.

Carrier Network Listings

9 networks across 4 carriers

Anthem(1 network)

1 DOI 6C-3

Anthem Blue Cross Blue ShieldDOI 6C-3

View carrier →

UnitedHealthcare(5 networks)

1 DOI 6C-34 Federal TiC

UnitedHealthcare of ColoradoDOI 6C-3

View carrier →

UnitedHealthcare InsuranceFederal TiC

View carrier →

UnitedHealthcare ServicesFederal TiC

View carrier →

Related Investigations

All providers in Anthem Blue Cross Blue Shield networkView →All Physical Therapist providers statewideView →All providers in WESTMINSTER 80003View →All providers classified as Needs ReviewView →

Known Addresses

NPPESWESTMINSTER, 80003

Care CompareGOLDEN, 80401

Care CompareWESTMINSTER, 80003

Evidence

9647 items across 16 assertions from 13 sources

Connected Records

Colorado License

Expired

DORA

Practice Address

GOLDEN, 80401

cms_care_compare, NPPES

Carrier Network Listing

Listed in 9 carrier networks

TiC: Anthem Blue Cross Blue Shield, TiC: UnitedHealthcare Services, TiC: UnitedHealthcare Insurance, TiC: UnitedHealthcare (UMR), TiC: UnitedHealthcare Colorado, TiC: UnitedHealthcare (Surest), TiC: Kaiser Permanente Insurance Company, TiC: Aetna, TiC: Kaiser Permanente

NPI Registration

Status: active

NPPES Deactivation

entity_type

Record found

NPPES

Federal Exclusion Check

No exclusion found

OIG LEIE + SAM.gov

Evidence Lineage

Carrier Network ListingTrust: 0.80

↓TiC: Anthem Blue Cross Blue Shield9595 records ·weight 0.80 · Latest: Mar 14, 2026

Carrier Network ListingTrust: 0.80

↓TiC: Anthem Blue Cross Blue Shield8 records ·weight 0.80 · Latest: Mar 14, 2026

Colorado License StatusTrust: 0.95

↓DORA3 records ·weight 0.95 · Latest: Mar 13, 2026

Matched via: primary

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare Services7 records ·weight 0.80 · Latest: Mar 12, 2026

Carrier Network ListingTrust: 0.80

Timeline

Mar 14, 2026Carrier listing: Anthem Blue Cross Blue Shield

Mar 13, 2026DORA license check: Expired

Mar 12, 2026Carrier listing: UnitedHealthcare Services

Mar 12, 2026Carrier listing: UnitedHealthcare Insurance

Mar 12, 2026NPPES record: active

Mar 12, 2026Carrier listing: UnitedHealthcare (UMR)

Mar 12, 2026Carrier listing: UnitedHealthcare Colorado

Mar 11, 2026Carrier listing: UnitedHealthcare (Surest)

Mar 11, 2026Carrier listing: Kaiser Permanente Insurance Company

Mar 11, 2026Carrier listing: Aetna

Mar 6, 2026

Evidence

Loading evidence lineage...

Disclaimer: This analysis uses publicly available federal and state data sources. It does not constitute a determination of provider status or network participation. Contact the provider or health plan directly to verify current status.

Evidence

9647 items across 16 assertions from 13 sources

Connected Records

Colorado License

Expired

DORA

Practice Address

GOLDEN, 80401

cms_care_compare, NPPES

Carrier Network Listing

Listed in 9 carrier networks

NPI Registration

Status: active

NPPES Deactivation

entity_type

Record found

NPPES

Federal Exclusion Check

No exclusion found

OIG LEIE + SAM.gov

Evidence Lineage

Carrier Network ListingTrust: 0.80

↓TiC: Anthem Blue Cross Blue Shield9595 records ·weight 0.80 · Latest: Mar 14, 2026

Carrier Network ListingTrust: 0.80

↓TiC: Anthem Blue Cross Blue Shield8 records ·weight 0.80 · Latest: Mar 14, 2026

Colorado License StatusTrust: 0.95

↓DORA3 records ·weight 0.95 · Latest: Mar 13, 2026

Matched via: primary

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare Services7 records ·weight 0.80 · Latest: Mar 12, 2026

Carrier Network ListingTrust: 0.80

Timeline

Mar 14, 2026Carrier listing: Anthem Blue Cross Blue Shield

Mar 13, 2026DORA license check: Expired

Mar 12, 2026Carrier listing: UnitedHealthcare Services

Mar 12, 2026Carrier listing: UnitedHealthcare Insurance

Mar 12, 2026NPPES record: active

Mar 12, 2026Carrier listing: UnitedHealthcare (UMR)

Mar 12, 2026Carrier listing: UnitedHealthcare Colorado

Mar 11, 2026Carrier listing: UnitedHealthcare (Surest)

Mar 11, 2026Carrier listing: Kaiser Permanente Insurance Company

Mar 11, 2026Carrier listing: Aetna

Mar 6, 2026