Debra Christine Feldott-Johnson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036-101335 Issued in IL

Practice address

1250 Mercantile Dr
Highland, IL 62249-1239

Phone

(618) 654-4449

Fax

(618) 654-3974

NPI assigned

Aug 16, 2005

Last updated

Oct 13, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: admin@highlandpediatrics.e-mdsdirect.com

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.

• Highland Pediatrics & Adolescent Medicine

  • Pediatrics Physician
  • Highland, IL
  • NPI 1942321773
  NPD (past) Authorized official

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1184616286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 MERCANTILE DR",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491239",
            "telephone_number": "618-654-4449",
            "fax_number": "618-654-3974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 MERCANTILE DR",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491239",
            "telephone_number": "618-654-4449",
            "fax_number": "618-654-3974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDOTT-JOHNSON",
        "first_name": "DEBRA",
        "middle_name": "CHRISTINE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-101335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101335",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Brianna Feliciano
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• Carli Rae Fields
• Christina M Frank, PT, MBA
• Kane M Freeman, PT

• Pediatrics Physician in Highland, IL
• Providers in Highland, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.