Active NPI
Helene M Johnson, MD
- General Practice Physician
- Niles, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 4301030791
- Practice address
- 42 N Saint Joseph Ave
Suite 200
Niles, MI 49120-2203 - Phone
- (269) 687-0808
- Fax
- (269) 687-0811
- NPI assigned
- Jun 30, 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 4301030791 | MI | Primary |
Addresses
Primary practice location
42 N Saint Joseph Ave
Suite 200
Niles, MI 49120-2203
Mailing address
6416 Deans Hill Rd
Berrien Center, MI 49102-9750
Phone (269) 471-7741
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01-31142 | Other | MI | PHP |
| 1013408 | Other | MI | CIGNA |
| 0101151112 | Other | MI | BLUE CROSS |
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- University of California, San Francisco School of Medicine, 1971
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9625 Red Arrow Hwy
Bridgman, MI 49106-9559
Phone (269) 465-6050
Hospital & facility affiliations
- Lakeland Hospital, St Joseph
- Corewell Health Rehabilitation & Nursing Center -
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301030791 | MI | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complexcare Medical Group Midwest H PLLC | Current | Accepting new patients | |
| Theoria Medical | Current | Accepting new patients | |
| Mercy Memorial Health Services Inc | Past | Accepting new patients |
Locations
5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216
6700 W Outer Dr
Detroit, MI 48235
Phone (313) 836-1700
4436 Beecher Rd
Flint, MI 48532
Phone (810) 223-9324
3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300
41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763
Interoperability endpoints
- hjohnson1270144@epic00.corewelldirect.org
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Saint Joseph, MI
- NPI 1538397120
-
- Internal Medicine Physician
- Novi, MI
- NPI 1457144933
-
- Internal Medicine Physician
- Novi, MI
- NPI 1609362375
-
- Skilled Nursing Facility
- Stevensville, MI
- NPI 1003802596
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Joseph, MI
- NPI 1134220031
-
- Skilled Nursing Facility
- Stevensville, MI
- NPI 1003802596
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1215966528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6416 DEANS HILL RD",
"city": "BERRIEN CENTER",
"state": "MI",
"postal_code": "491029750",
"telephone_number": "269-471-7741",
"fax_number": "269-471-1581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42 N SAINT JOSEPH AVE",
"address_2": "SUITE 200",
"city": "NILES",
"state": "MI",
"postal_code": "491202203",
"telephone_number": "269-687-0808",
"fax_number": "269-687-0811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "HELENE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-30",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MI",
"license": "4301030791",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP",
"identifier": "01-31142",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1013408",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "0101151112",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Niles, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.