NPIMap

Individual provider Active NPI

Jennifer Edwards-Johnson, D.O

  • Family Medicine Physician
  • Lansing, MI
National Provider Identifier
1083972434
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101019898 Issued in MI
Practice address
1200 E Michigan Ave Ste 245a
Lansing, MI 48912-1852
Phone
(517) 364-5710
Fax
(517) 264-5717
NPI assigned
Apr 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101019898 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1200 E Michigan Ave Ste 245a
Lansing, MI 48912-1852

Mailing address

13820 Courtland St
Oak Park, MI 48237-2723
Phone (517) 420-3045

Other practice location 1

22250 Providence Dr
Suite 500
Southfield, MI 48075-4825
Phone (248) 849-3441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150623001940 MI Practitioner - Family Practice 6709197569 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren FlintGroup PAC ID 8628975497, 144 clinicians

Practice addresses (Care Compare)

G3230 Beecher Rd
Suite 1
Flint, MI 48532-3604
Phone (810) 342-5656

Hospital & facility affiliations

  • McLaren Flint Hospital, Flint, MI, CCN 230141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Flint Family Medicine CurrentSince Jul 1, 2021 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
McLaren Flint Current Accepting new patients
Edward W. Sparrow Hospital Association Family Medicine CurrentSince Jul 1, 2015 Accepting new patients
McLaren Flint CurrentSince Jul 1, 2021 Accepting new patients
Edward W Sparrow Hospital Association Family Medicine CurrentSince Jul 1, 2015 Accepting new patients
McLaren Flint Past Accepting new patients
McLaren Flint Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

2900 Hannah Blvd
Ste 204
East Lansing, MI 48823
Phone (517) 336-4590

G3230 Beecher Rd
Ste 1
Flint, MI 48532
Phone (810) 342-5620

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1200 E Michigan Ave
Ste 245A
Lansing, MI 48912
Phone (517) 364-5710

800 E Columbia St
Mason, MI 48854
Phone (517) 244-8900

Organizations & group practices 12

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

Hospital & facility affiliations 1

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": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1083972434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13820 COURTLAND ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372723",
            "telephone_number": "517-420-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E MICHIGAN AVE STE 245A",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121852",
            "telephone_number": "517-364-5710",
            "fax_number": "517-264-5717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22250 Providence Dr",
            "address_2": "Suite 500",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480754825",
            "country_code": "US",
            "telephone_number": "248-849-3441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS-JOHNSON",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101019898",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.