Active NPI
Nicole Theresa Johnson, CNM
- Midwife
- Sioux Falls, SD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- CM000094
- Practice address
- 1417 S Cliff Ave Ste 400a
Sioux Falls, SD 57105-1064 - Phone
- (605) 322-8946
- NPI assigned
- Jan 4, 2022
- Last updated
- Jan 4, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | CM000094 | SD | Primary |
Addresses
Primary practice location
1417 S Cliff Ave Ste 400a
Sioux Falls, SD 57105-1064
Mailing address
3112 S 5TH Ave
Sioux Falls, SD 57105-5904
Phone (605) 351-4207
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CM000094 | SD | MD | Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avera McKennan | Current | Accepting new patients | |
| Avera McKennan | Current | Accepting new patients | |
| Avera McKennan | Current | Accepting new patients | |
| Avera McKennan | Past | Accepting new patients | |
| Avera McKennan | Past | Accepting new patients |
Locations
1417 S Cliff Ave
Ste 400A
Sioux Falls, SD 57105
Phone (605) 322-8877
1417 S Cliff Ave
Ste 401
Sioux Falls, SD 57105
Phone (605) 322-8920
Organizations & group practices 5
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.
-
dba Avera McKennan Behavioral Health Clinic
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Sioux Falls, SD
- NPI 1699009944
-
dba Avera Medical Group Urogynecology Sioux Falls
- Obstetrics & Gynecology Physician
- Sioux Falls, SD
- NPI 1003188269
-
dba Avera Interventional Radiology
- Diagnostic Radiology Physician
- Sioux Falls, SD
- NPI 1053680678
-
dba Avera Medical Group 69th and Cliff
- Family Medicine Physician
- Sioux Falls, SD
- NPI 1144635863
-
dba Avera McKennan Hospital and University Health Center
- General Acute Care Hospital
- Sioux Falls, SD
- NPI 1568460772
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641254400000",
"number": "1477214351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3112 S 5TH AVE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571055904",
"telephone_number": "605-351-4207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1417 S CLIFF AVE STE 400A",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571051064",
"telephone_number": "605-322-8946"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "NICOLE",
"middle_name": "THERESA",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-04",
"last_updated": "2022-01-04",
"certification_date": "2022-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "SD",
"license": "CM000094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.