Active NPI
Linda A Johnson, CNM
- Midwife
- Berkeley, CA
National Provider Identifier
1104984764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 516
- Practice address
- 2107 Dwight Way
Suite 102
Berkeley, CA 94704 - Phone
- (510) 644-0104
- Fax
- (510) 649-0219
- NPI assigned
- Dec 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 516 | CA | Primary |
Addresses
Primary practice location
2107 Dwight Way
Suite 102
Berkeley, CA 94704
Mailing address
2107 Dwight Way Ste 102
Berkeley, CA 94704-2028
Phone (510) 644-0104
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7550813 | Medicaid | CA |
Other names 1
- Lindy Johnson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Nurse Midwife
Interoperability endpoints
- ljohnson160293@hisp.ehr.sutterhealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1104984764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2107 DWIGHT WAY STE 102",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947042028",
"telephone_number": "510-644-0104",
"fax_number": "510-649-0219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2107 DWIGHT WAY",
"address_2": "SUITE 102",
"city": "BERKELEY",
"state": "CA",
"postal_code": "94704",
"telephone_number": "510-644-0104",
"fax_number": "510-649-0219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "LINDA",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "CA",
"license": "516",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7550813",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LINDY",
"last_name": "JOHNSON",
"credential": "CNM",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.