Stephanie Ann Johnson, NP
Individual provider Active NPI Nurse Practitioner · Springport, MI
NPI 1154723344 · NPPES record last updated Jan 15, 2024
Key facts
- NPI
- 1154723344
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 4704289405 (MI)
- Practice address
- 300 W Main St
Springport, MI 49284-9517 - Phone
- (517) 857-3495
- NPI assigned
- Sep 19, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240123004623 | MI | Practitioner - Nurse Practitioner | 2466804620 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of Michigan | Nurse Practitioner | Current | Accepting new patients |
| Regents of the University of Michigan | Current |
Accepting new patients | |
| Regents of the University of Michigan | Nurse Practitioner | Current |
Accepting new patients |
| Regents of the University of Michigan | Past |
Accepting new patients |
Locations
1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280
3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229
8001 Challis Rd
Brighton, MI 48116
Phone (810) 227-9510
Interoperability endpoints
- sjohnson443311@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 4704289405 | MI | |
| Nurse Practitioner | 363L00000X | 4704289405 | MI | Yes |
Addresses
Primary practice location
300 W Main St
Springport, MI 49284-9517
Mailing address
3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299
Other practice location 1
2100 4th St
Jackson, MI 49203-4518
Phone (517) 787-4330
Other providers in Springport, MI
- Jeffrey Gerard Brenner
- Elissa A Ditzel
- Michelle Marie Kolassa
- Kelly Michele Lane
- Lisa Michelle Rae
- Simply Smiles Inc.
All providers in Springport, MI · Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.