Jane Wagema-Johnson, GNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

242191 Issued in MA

Practice address

100 Cummings Ctr
Suite 222C
Beverly, MA 01915-6115

Phone

(978) 524-9510

NPI assigned

May 11, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Wellworth Homecare Services Inc.

  • Home Health Agency
  • Chelmsford, MA
  • NPI 1285002303

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership

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.

• Matrix Medical Plus

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1376973461

  MA

  Medicare reassignment NPD
• Wellworth Homecare Services Inc.

  • Home Health Agency
  • Chelmsford, MA
  • NPI 1285002303
  NPD Authorized official
• Beacon Hospice, LLC

  • Community Based Hospice Care Agency
  • Marlborough, MA
  • NPI 1043335011
  NPD (past)

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336694400000",
    "number": "1316206352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR",
            "address_2": "SUITE 222C",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156115",
            "telephone_number": "978-524-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR",
            "address_2": "SUITE 222C",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156115",
            "telephone_number": "978-524-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGEMA-JOHNSON",
        "first_name": "JANE",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-11",
        "last_updated": "2012-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "242191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vive Therapy
• Jacquelyn Vo, BSW
• Dominick Charles Vogus
• W & K Goodwin Ventures Incorporated
• Sanjeev Wadhwa, CRNA
• Mary Jo Wagner, OTR/L
• Lucy W Wahinya
• Joanne S Waite, NYS LMHC, NCC
• Andree Walch, M.A.
• Leonore Kristine Wald, PA-C

• Gerontology Nurse Practitioner in Beverly, MA
• Providers in Beverly, MA by specialty
• Gerontology Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.