Individual provider Active NPI

Lynne M Johnson, M.D.

  • Pediatrics Physician
  • Greenville, PA
National Provider Identifier
1225004336
Registry record updated Jun 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD421255 Issued in PA
Practice address
348 Main St
Greenville, PA 16125-2608
Phone
(724) 588-5250
Fax
(724) 588-5253
NPI assigned
Feb 28, 2006
Last updated
Jun 9, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD421255 PA Primary

Addresses

Primary practice location

348 Main St
Greenville, PA 16125-2608

Mailing address

PO Box 716
100 Shenango Avenue
Sharon, PA 16146-0716
Phone (724) 588-5250

Other identifiers 1

IdentifierTypeStateIssuer
0019567800002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20060425000388 PA Practitioner - Pediatric Medicine 1759391519 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Network CurrentSince May 21, 2015 Accepting new patients
Primary Health Network CurrentSince May 21, 2015 Accepting new patients
Primary Health Network Past Accepting new patients
Greenville Medical Center Pediatrics Past Accepting new patients

Locations

2000 Green St
Farrell, PA 16121
Phone (724) 342-6600

348 Main St
Greenville, PA 16125
Phone (724) 588-5250

63 Pitt St
Sharon, PA 16146
Phone (724) 342-6604

Interoperability endpoints

  • Direct secure messaging: lynnejohnson@primaryhn.medalliesdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496966400000",
    "number": "1225004336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 716",
            "address_2": "100 SHENANGO AVENUE",
            "city": "SHARON",
            "state": "PA",
            "postal_code": "161460716",
            "telephone_number": "724-588-5250",
            "fax_number": "724-588-5253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 MAIN ST",
            "city": "GREENVILLE",
            "state": "PA",
            "postal_code": "161252608",
            "telephone_number": "724-588-5250",
            "fax_number": "724-588-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LYNNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2017-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD421255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019567800002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, PA

Sources for this page

Verify at the official NPI Registry.