Individual provider Active NPI

Helene M Johnson, MD

  • General Practice Physician
  • Niles, MI
National Provider Identifier
1215966528
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
4301030791 Issued in MI
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

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
01-31142OtherMIPHP
1013408OtherMICIGNA
0101151112OtherMIBLUE 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031204000425 MI Practitioner - General Practice 6406769785 Reassigns benefits to 3 organizations

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
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

9625 Red Arrow Hwy
Bridgman, MI 49106-9559
Phone (269) 465-6050

Hospital & facility affiliations

  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
  • Corewell Health Rehabilitation & Nursing Center - Nursing home, Stevensville, MI, CCN 235164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301030791MIMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Complexcare Medical Group Midwest H PLLC CurrentSince Sep 13, 2025 Accepting new patients
Theoria Medical CurrentSince Jun 2, 2025 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.