Individual provider Active NPI

Emily Johanna Johnson, D.C.

  • Chiropractor
  • New Berlin, WI
National Provider Identifier
1477086486
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5271-12 Issued in WI
Practice address
16645 W Greenfield Ave Ste D
New Berlin, WI 53151-1546
Phone
(262) 788-5940
NPI assigned
Apr 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 086694 IA
Chiropractor 111N00000X 5271-12 WI Primary

Addresses

Primary practice location

16645 W Greenfield Ave Ste D
New Berlin, WI 53151-1546

Mailing address

16645 W Greenfield Ave Ste D
New Berlin, WI 53151-1546
Phone (262) 788-5940

Other practice location 1

147 N State St
Berlin, WI 54923-1621
Phone (920) 361-3515

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170417001766 WI Practitioner - Chiropractic 7416233960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16645 W Greenfield Ave
Suite D
New Berlin, WI 53151-1546
Phone (262) 788-5940

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
086694IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Renewed Health Family Chiropractic LLC CurrentSince Mar 20, 2019 Accepting new patients
Back & Body Therapeutic Touch, LLC PastSince Apr 11, 2017 Accepting new patients

Locations

16645 W Greenfield Ave
Ste D
New Berlin, WI 53151
Phone (262) 788-5940

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.

NPI Registry JSON

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1477086486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16645 W GREENFIELD AVE STE D",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531511546",
            "telephone_number": "262-788-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16645 W GREENFIELD AVE STE D",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531511546",
            "telephone_number": "262-788-5940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 N State St",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "WI",
            "postal_code": "549231621",
            "country_code": "US",
            "telephone_number": "920-361-3515",
            "fax_number": "920-361-2733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EMILY",
        "middle_name": "JOHANNA",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-06",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "086694",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5271-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Berlin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.