Individual provider Active NPI

Deeanne Joy Johnson-Engle, M.D.

  • Family Medicine Physician
  • Douglas, WY
National Provider Identifier
1346433554
Registry record updated Aug 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7739A Issued in WY
Practice address
111 S 5TH St
Douglas, WY 82633-2434
Phone
(307) 358-2122
Fax
(307) 358-9216
NPI assigned
Aug 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7739A WY Primary

Addresses

Primary practice location

111 S 5TH St
Douglas, WY 82633-2434

Mailing address

PO Box 1450
Douglas, WY 82633-1450
Phone (307) 358-2122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20070919000800 WY Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 2769576800 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
University of Washington School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital of Converse County 77 clinicians

Practice addresses (Care Compare)

111 S 5TH St
Douglas, WY 82633-2434
Phone (307) 358-2122

Hospital & facility affiliations

  • Memorial Hospital of Converse County Hospital, Douglas, WY, CCN 531302
  • Memorial Hospital of Converse County Nursing home, CCN 53Z302

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital of Converse County CurrentSince Sep 13, 2007 Accepting new patients
Memorial Hospital of Converse County Current Accepting new patients

Locations

700 E Center St
Douglas, WY 82633
Phone (307) 352-8946

111 S 5th St
Douglas, WY 82633
Phone (307) 358-6200

Interoperability endpoints

  • Direct secure messaging: dengle@direct.mhccwyo.org

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 2

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": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187654400000",
    "number": "1346433554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1450",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826331450",
            "telephone_number": "307-358-2122",
            "fax_number": "307-358-9216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 5TH ST",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826332434",
            "telephone_number": "307-358-2122",
            "fax_number": "307-358-9216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-ENGLE",
        "first_name": "DEEANNE",
        "middle_name": "JOY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-21",
        "last_updated": "2007-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "7739A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, WY

Sources for this page

Verify at the official NPI Registry.