Heather Johnson, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601004334 Issued in MI

Practice address

990 W Ann Arbor TRL
Plymouth, MI 48170-6204

Phone

(734) 414-1099

Fax

(734) 414-1065

NPI assigned

May 9, 2007

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

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Robert Vartabedian, M.D.

  • Internal Medicine Physician
  • Plymouth, MI
  • NPI 1356310114
  Medicare reassignment

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366656449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 W ANN ARBOR TRL",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706204",
            "telephone_number": "734-414-1099",
            "fax_number": "734-414-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 W ANN ARBOR TRL",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706204",
            "telephone_number": "734-414-1099",
            "fax_number": "734-414-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HEATHER",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "5601004334",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cydni Johnson
• Daniel Johnson
• Dante Johnson
• Dawn C Johnson, IONM TECH
• Grant Ernest Johnson
• James Clifford Johnson, DDS
• Julie Johnson
• Justice Johnson
• Pauline Johnson
• Robert Steven Johnson II, CCP

• Medical Physician Assistant in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.