Individual provider Active NPI

Michelle Dawn Johnson

  • Family Nurse Practitioner
  • Marquette, MI
National Provider Identifier
1083015424
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704212503 Issued in MI
Practice address
2003 Orchard St
Marquette, MI 49855
Phone
(906) 360-1080
NPI assigned
Sep 4, 2014
Last updated
Sep 4, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704212503 MI Primary

Addresses

Primary practice location

2003 Orchard St
Marquette, MI 49855

Mailing address

2003 Orchard St
Marquette, MI 49855-2407
Phone (906) 360-1080

Other names 1

  • Michelle Dawn Paquet Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141030001384 MI Practitioner - Nurse Practitioner 0345461620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1414 W Fair Ave
Marquette, MI 49855-5407
Phone (906) 225-3910

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc CurrentSince Sep 19, 2014 Accepting new patients
DLP Marquette Physician Practices Inc Current Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Sep 19, 2014 Accepting new patients
DLP Marquette Physician Practices Inc Past Accepting new patients

Locations

1414 W Fair Ave
Ste 344
Marquette, MI 49855
Phone (906) 225-3910

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: michelle.johnson.1@8233.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1083015424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 ORCHARD ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552407",
            "telephone_number": "906-360-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 ORCHARD ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-360-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHELLE",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704212503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "PAQUET",
            "middle_name": "DAWN",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.