Active NPI
Dawn Marie Johnson, NP
- Psychiatric/Mental Health Nurse Practitioner
- Mishawaka, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 71008402A
- Practice address
- 215 W 4TH St
Mishawaka, IN 46544-1917 - Phone
- (574) 325-5961
- NPI assigned
- Sep 19, 2018
- Last updated
- Nov 18, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 71008402A | IN | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 71008402A | IN | Primary |
| Registered Nurse | 163W00000X | 28192361A | IN |
Addresses
Primary practice location
215 W 4TH St
Mishawaka, IN 46544-1917
Mailing address
215 W 4TH St
Mishawaka, IN 46544-1917
Phone (574) 325-5961
Other practice location 1
215 W 4th St Ste 101
Mishawaka, IN 46544-1917
Phone (574) 544-0608
Other practice location 2
215 W 4th St Ste 400
Mishawaka, IN 46544-1917
Phone (574) 544-0416
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28192361A | IN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana Center for Recovery Outpatient Services LLC | Current | Accepting new patients | |
| Indiana Center for Recovery Outpatient Services LLC | Current | Accepting new patients | |
| Indiana University Health Bloomington Inc | Psychiatric/Mental Health | Current | Accepting new patients |
| Indiana University Health Bloomington Inc | Current | Accepting new patients | |
| Indiana Center for Recovery South Bend, LLC | Past | Accepting new patients |
Locations
7987 Solution Ctr
Chicago, IL 60677
601 W 2nd St
Bloomington, IN 47403
Phone (812) 353-5252
727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450
714 N Senate Ave
Ste 130
Indianapolis, IN 46202
Phone (317) 963-5582
1578 E 85th Ave
Merrillville, IN 46410
Phone (219) 736-8955
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Merrillville, IN
- NPI 1093412793
-
- Multi-Specialty Clinic/Center
- Bloomington, IN
- NPI 1013953983
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Carmel, IN
- NPI 1639869464
-
- Psychiatry Physician
- Bloomington, IN
- NPI 1871519074
Psychiatric/Mental Health
-
dba IU Health Bloomington Retail Pharmacy
- Community/Retail Pharmacy
- Bloomington, IN
- NPI 1922640077
-
dba Hoosier Wellness Providers
- Psychiatric Hospital
- Mishawaka, IN
- NPI 1326790262
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731888000000",
"number": "1467936070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 W 4TH ST",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465441917",
"telephone_number": "574-325-5961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 W 4TH ST",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465441917",
"telephone_number": "574-325-5961"
}
],
"practiceLocations": [
{
"address_1": "215 W 4th St Ste 101",
"address_purpose": "LOCATION",
"city": "Mishawaka",
"state": "IN",
"postal_code": "465441917",
"country_code": "US",
"telephone_number": "574-544-0608",
"fax_number": "574-544-0070",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "215 W 4th St Ste 400",
"address_purpose": "LOCATION",
"city": "Mishawaka",
"state": "IN",
"postal_code": "465441917",
"country_code": "US",
"telephone_number": "574-544-0416",
"fax_number": "574-544-0066",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "DAWN",
"middle_name": "MARIE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-19",
"last_updated": "2024-11-18",
"certification_date": "2024-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71008402A",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IN",
"license": "71008402A",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IN",
"license": "28192361A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mishawaka, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.