Stephanie Ann Johnson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704289405 Issued in MI

Practice address

300 W Main St
Springport, MI 49284-9517

Phone

(517) 857-3495

NPI assigned

Sep 19, 2014

Last updated

Jan 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sjohnson443311@direct.hfhs.org

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.

• Regents of the University of Michigan

  • Nurse Practitioner
  • Ann Arbor, MI
  • NPI 1447275102
  Medicare reassignment NPD
• Regents of the University of Michigan

  • Nurse Practitioner
  • Brighton, MI
  • NPI 1225053895
  NPD
• Regents of the University of Michigan

  • Specialty Pharmacy
  • Dexter, MI
  • NPI 1952181919
  NPD
• Regents of the University of Michigan

  dba University of Michigan Health System

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  NPD (past)

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1154723344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W MAIN ST",
            "city": "SPRINGPORT",
            "state": "MI",
            "postal_code": "492849517",
            "telephone_number": "517-857-3495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 4th St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492034518",
            "country_code": "US",
            "telephone_number": "517-787-4330",
            "fax_number": "517-787-4861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-19",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704289405",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704289405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Gerard Brenner, PA-C
• Elissa A Ditzel, OTRL
• Michelle Marie Kolassa, RN
• Kelly Michele Lane, AT
• Lisa Michelle Rae, MSW
• Simply Smiles Inc. (Simply Smiles)

• Nurse Practitioner in Springport, MI
• Providers in Springport, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.