Abigail Anne Johnson, M.A.
Individual provider Active NPI Audiologist · Elkhart, IN
NPI 1194078634 · NPPES record last updated Oct 6, 2015
Key facts
- NPI
- 1194078634
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 23002329A (IN)
- Practice address
- 303 S Nappanee St
Elkhart, IN 46514-2066 - Phone
- (574) 296-3200
- Fax
- (574) 296-3392
- NPI assigned
- Oct 22, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group Indiana, LLC | Current |
Accepting new patients | |
| Privia Medical Group Indiana, LLC | Current | Accepting new patients | |
| Onsight, Inc. | Past | Accepting new patients | |
| Giaimo Mobile Podiatry of WV PLLC | Past | Accepting new patients | |
| Onhealthcare LLC | Past | Accepting new patients |
Locations
303 S Nappanee St
Elkhart, IN 46514
Interoperability endpoints
- abigail.johnson@elkhartc.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 1601000628 | MI | |
| Audiologist | 231H00000X | 23002329A | IN | Yes |
Addresses
Primary practice location
303 S Nappanee St
Elkhart, IN 46514-2066
Mailing address
PO Box 2968
Elkhart, IN 46515-2968
Phone (574) 296-3200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201080690 | Medicaid | IN | |
| 23002329A | Other | IN | STATE LICENSE |
Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.