Individual provider Active NPI

Jason Richard Johnson, FNP

  • Family Nurse Practitioner
  • Three Rivers, MI
National Provider Identifier
1225596125
Registry record updated Mar 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704301030 Issued in MI
Practice address
633 S Erie St
Three Rivers, MI 49093-2073
Phone
(269) 273-6670
NPI assigned
Mar 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704301030 MI Primary

Addresses

Primary practice location

633 S Erie St
Three Rivers, MI 49093-2073

Mailing address

123 E Crawford St
Findlay, OH 45840-4802

Other practice location 1

570 Linn St Ste 2
Allegan, MI 49010-1572
Phone (269) 686-4300

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190416001382 MI Practitioner - Nurse Practitioner 9032450267 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ella E M Brown Charitable CircleGroup PAC ID 1254228745, 172 clinicians

Practice addresses (Care Compare)

200 N Madison St
Marshall, MI 49068-1143
Phone (269) 781-4271

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.06 of 100Reported as group
Quality
85.32
Promoting interoperability
100
Improvement activities
40
Cost
71.56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704301030MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ella E M Brown Charitable Circle Current Accepting new patients
Ella E M Brown Charitable Circle CurrentSince Oct 1, 2020 Accepting new patients
Ella E M Brown Charitable Circle Nurse Practitioner CurrentSince Oct 1, 2020 Accepting new patients
Pain Management Group PLLC CurrentSince Apr 1, 2019 Accepting new patients
Pain Management Group LLC Nurse Practitioner Past Accepting new patients

Locations

570 Linn St
Ste 2
Allegan, MI 49010
Phone (269) 673-3619

555 Linn St
Allegan, MI 49010
Phone (269) 673-8424

200 N Madison St
Marshall, MI 49068
Phone (269) 789-3921

701 S Health Parkway
Three Rivers, MI 49093
Phone (269) 273-9691

633 S Erie St
Three Rivers, MI 49093
Phone (269) 273-8557

123 E Crawford St
Findlay, OH 45840

Interoperability endpoints

  • Direct secure messaging: jason.johnson.1@9698.direct.athenahealth.com

Organizations & group practices 5

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 1

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": "1552089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552089600000",
    "number": "1225596125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 E CRAWFORD ST",
            "city": "FINDLAY",
            "state": "OH",
            "postal_code": "458404802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 S ERIE ST",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490932073",
            "telephone_number": "269-273-6670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "570 Linn St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Allegan",
            "state": "MI",
            "postal_code": "490101572",
            "country_code": "US",
            "telephone_number": "269-686-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JASON",
        "middle_name": "RICHARD",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-09",
        "last_updated": "2019-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704301030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Three Rivers, MI

Sources for this page

Verify at the official NPI Registry.