Individual provider Active NPI

Vietta Louise Johnson, M.D.

  • Orthopaedic Surgery Physician
  • Hammond, IN
National Provider Identifier
1285686899
Registry record updated Jul 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
01045972A Issued in IN
Practice address
5454 S Hohman Ave
Hammond, IN 46320-1931
Phone
(219) 933-2654
Fax
(219) 933-2655
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 01045972A IN Primary

Addresses

Primary practice location

5454 S Hohman Ave
Hammond, IN 46320-1931

Mailing address

PO Box 1000
Dyer, IN 46311-0800
Phone (219) 864-2107

Other identifiers 1

IdentifierTypeStateIssuer
200136030MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060718000060 IN Practitioner - Orthopedic Surgery 7911910971 Reassigns benefits to 1 organization
I20150515001029 IL Practitioner - Orthopedic Surgery 7911910971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Harvard Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foundation for Outreach ServicesGroup PAC ID 3375507163, 36 clinicians

Practice addresses (Care Compare)

326 W 64TH St
Chicago, IL 60621-3114
Phone (773) 962-3900

Hospital & facility affiliations

  • St Bernard Hospital Hospital, Chicago, IL, CCN 140103

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01045972AINMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Aug 1, 2011 Accepting new patients
Franciscan Physician Network CurrentSince Aug 1, 2011 Accepting new patients
Foundation for Outreach Services CurrentSince Apr 1, 2015 Accepting new patients

Locations

35682 Eagle Way
Chicago, IL 60678

326 W 64th St
#205
Chicago, IL 60621

326 W 64th St
Chicago, IL 60621
Phone (773) 962-3900

6307 S Stewart Ave
Fl 1
Chicago, IL 60621
Phone (773) 896-2565

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

5454 Hohman Ave
Hammond, IN 46320
Phone (219) 933-2077

10860 Maple Ln
Saint John, IN 46373
Phone (219) 365-7000

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Organizations & group practices 3

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311552000000",
    "number": "1285686899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463110800",
            "telephone_number": "219-864-2107",
            "fax_number": "219-864-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5454 S HOHMAN AVE",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463201931",
            "telephone_number": "219-933-2654",
            "fax_number": "219-933-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VIETTA",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2011-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "01045972A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200136030",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, IN

Sources for this page

Verify at the official NPI Registry.