Ellen Johnson, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

EJ008605 Issued in MI

Practice address

4165 E Lippincott Blvd
Burton, MI 48519

Phone

(810) 744-1883

NPI assigned

Mar 6, 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

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Catholic Charities of Shiawassee and Genesee CountiesGroup PAC ID 9537158068, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Catholic Charities of Shiawassee and Genesee Counties

  • Mental Health Counselor
  • Owosso, MI
  • NPI 1801819149
  Medicare reassignment Care Compare group NPD
• Catholic Charities of Shiawassee and Genesee Counties

  • Mental Health Counselor
  • Owosso, MI
  • NPI 1689155590
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407986813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4165 E LIPPINCOTT BLVD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "48519",
            "telephone_number": "810-744-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4165 E LIPPINCOTT BLVD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "48519",
            "telephone_number": "810-744-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ELLEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "EJ008605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John M. Sullivan DDS, PLLC
• Arianna Elaine Johnson-Massie
• Ajah Monet Johnson
• Amaria Johnson
• Christine Marie Johnson
• Heather Johnson
• Heather Jones
• Lunden Anyia Renee Jones
• Tammy Sue Jones
• Kristina Linn Jordan, FNP-BC

• Psychiatry Physician in Burton, MI
• Providers in Burton, MI by specialty
• Psychiatry Physician 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.