Elise Johanson Doll, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

25ME00071401 Issued in NJ

Practice address

1200 Old York Rd
Abington, PA 19001-3720

Phone

(215) 481-2000

NPI assigned

Mar 16, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Elise Kirsten Johanson Former name

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in NJ, PA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

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.

• Virtua Medical Group, PA

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1649226515

  PA, Single Specialty

  Medicare reassignment NPD
• Virtua Medical Group, PA

  • Orthopaedic Surgery Physician
  • Delran, NJ
  • NPI 1841087988
  NPD
• Womencare OB GYN, P.C.

  • Specialist
  • Willow Grove, PA
  • NPI 1881631166

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1336775931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 OLD YORK RD",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190013788",
            "telephone_number": "215-481-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 OLD YORK RD",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190013720",
            "telephone_number": "215-481-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Bowman Dr Fl 1",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439612",
            "country_code": "US",
            "telephone_number": "856-247-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOLL",
        "first_name": "ELISE",
        "middle_name": "JOHANSON",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-16",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "PA",
            "license": "MW010570",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NJ",
            "license": "25ME00071401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNM LICENSE",
            "identifier": "MW010570",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edoll258335@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr Fl 1",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edoll258335@directvirtua.org",
            "affiliation": "N",
            "address_1": "1600 Haddon Ave Fl 4",
            "city": "Camden",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "081033101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edoll258335@directvirtua.org",
            "affiliation": "N",
            "address_1": "175 Madison Ave Fl 3",
            "city": "Mount Holly",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080602099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELISE",
            "last_name": "JOHANSON",
            "middle_name": "KIRSTEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gina Marie Diluzio, MS
• Phu A Dinh, CRNP
• Dion R. Ehrlich, M.D., LTD.
• Jacqueline Dipietro, DPT
• Kathleen Dittrich
• Frank R Domeracki, M.D.
• Elizabeth A Dominguez, AGACNP
• Donna M Angotti MD SP
• Edward James Donnelly III, R. PH.
• Kathryn Ann Donnelly, DO

• Advanced Practice Midwife in Abington, PA
• Providers in Abington, PA by specialty
• Advanced Practice Midwife in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.