Individual provider Active NPI

Leah Michelle Johnson-Williams, NP-C

  • Family Nurse Practitioner
  • Merrillville, IN
National Provider Identifier
1457697898
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71004244A Issued in IN
Practice address
6091 Broadway
Merrillville, IN 46410-2619
Phone
(219) 763-8112
Fax
(219) 884-2547
NPI assigned
Dec 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71004244A IN Primary

Addresses

Primary practice location

6091 Broadway
Merrillville, IN 46410-2619

Mailing address

PO Box 1430
Portage, IN 46368-9230
Phone (219) 763-8112

Other identifiers 1

IdentifierTypeStateIssuer
201160800MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20130506000483 IN Practitioner - Nurse Practitioner 8628215977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians
Chesterton Physical Therapy IncGroup PAC ID 3173683984, 191 clinicians

Practice addresses (Care Compare)

2211 E 10TH St
Hobart, IN 46342-5313
Phone (219) 945-9383

425 Sand Creek Dr
Suite C
Chesterton, IN 46304-1589

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc CurrentSince Feb 20, 2023 Accepting new patients

Locations

2211 E 10th St
Hobart, IN 46342
Phone (219) 942-8521

8757 Colorado St
Merrillville, IN 46410
Phone (219) 945-5969

8558 Broadway
Merrillville, IN 46410
Phone (219) 392-7084

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

Interoperability endpoints

  • Direct secure messaging: ljohnsonwilliams142784@ssdirect.comhs.org
  • Direct secure messaging: leah.johnsonwilliams.p1@direct.northshorehealth.nextgenshare.com

Organizations & group practices 2

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 5

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": "1355270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1457697898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1430",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463689230",
            "telephone_number": "219-763-8112",
            "fax_number": "219-764-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6091 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464102619",
            "telephone_number": "219-763-8112",
            "fax_number": "219-884-2547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-WILLIAMS",
        "first_name": "LEAH",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-12",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004244A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201160800",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.