Mary Alice Johnson, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

3976 Issued in AK

Practice address

3340 Providence Dr
Suite 366
Anchorage, AK 99508-4616

Phone

(907) 563-3026

Fax

(907) 562-6445

NPI assigned

Aug 19, 2006

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 AK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Providence Health & Services Washington

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1386759751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 PROVIDENCE DR",
            "address_2": "SUITE 366",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084616",
            "telephone_number": "907-563-3026",
            "fax_number": "907-562-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 PROVIDENCE DR",
            "address_2": "SUITE 366",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084616",
            "telephone_number": "907-563-3026",
            "fax_number": "907-562-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARY",
        "middle_name": "ALICE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "AK",
            "license": "3976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mackena Elsie Johnson
• Madison Johnson
• Maiya Brielle Johnson
• Maria Ruthe Johnson, BSW
• Martha Pearl Johnson, M.S. CCC-SLP
• Maureen Ann Johnson, OT
• Melinda Lee Johnson, CHA/P
• Michael Edward Johnson Jr., LMT
• Michelle Marie Johnson
• Morgan Johnson

• Neonatal-Perinatal Medicine Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Neonatal-Perinatal Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.