Individual provider Active NPI

John C Johnson, MD

  • Emergency Medicine Physician
  • Crown Point, IN
National Provider Identifier
1407967102
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01025146A Issued in IN
Practice address
5521 W Lincoln Hwy Ste 1a
Crown Point, IN 46307-1098
Phone
(219) 769-8284
Fax
(219) 769-8298
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01025146A IN Primary

Addresses

Primary practice location

5521 W Lincoln Hwy Ste 1a
Crown Point, IN 46307-1098

Mailing address

PO Box 4776
Bloomington, IN 47402-4776
Phone (812) 336-1690

Other identifiers 2

IdentifierTypeStateIssuer
01025146AOtherININ LICENSE
01025146BOtherINCSR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aberdeen Ventures, LTD. PastSince Mar 1, 2009 Accepting new patients
Porter-Starke Services Inc. PastSince Sep 1, 1986 Accepting new patients
The Methodist Hospitals, Inc PastSince Dec 1, 2018 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1407967102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4776",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474024776",
            "telephone_number": "812-336-1690",
            "fax_number": "812-349-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5521 W LINCOLN HWY STE 1A",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071098",
            "telephone_number": "219-769-8284",
            "fax_number": "219-769-8298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOHN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01025146A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN LICENSE",
            "identifier": "01025146A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSR",
            "identifier": "01025146B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.