NPIMap

Individual provider Active NPI

Rebecca J. Johnson, DO

  • Family Medicine Physician
  • Milford, IN
National Provider Identifier
1477597094
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02002877A Issued in IN
Practice address
201 S Main St
Milford, IN 46542-3004
Phone
(574) 658-4142
Fax
(574) 658-3160
NPI assigned
Jun 15, 2006
Last updated
Mar 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02002877A IN Primary

Addresses

Primary practice location

201 S Main St
Milford, IN 46542-3004

Mailing address

201 S Main St
Milford, IN 46542-3004
Phone (574) 658-4142

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rebecca.johnson@goshenhealthdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050603000954 IN Practitioner - Family Practice 6204879968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Goshen Health System IncGroup PAC ID 4880598572, 135 clinicians

Practice addresses (Care Compare)

201 S Main St
Milford, IN 46542-3004
Phone (574) 658-4142

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
02002877AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Health System Inc Family Medicine CurrentSince Jan 2, 2022 Accepting new patients
Goshen Health System Inc CurrentSince Jan 2, 2022 Accepting new patients
Warsaw Health System LLC Past Accepting new patients

Locations

2824 Elkhart Rd
Goshen, IN 46526
Phone (574) 534-6752

1150 Lincolnway S
Ligonier, IN 46767
Phone (260) 894-7135

Interoperability endpoints

  • Direct secure messaging: rebecca.johnson.1@28785.direct.athenahealth.com
  • Direct secure messaging: rebecca.johnson@goshenhealthdirect.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Miller's Merry ManorWarsaw, IN, CCN 155049 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2025
Aug 11, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1477597094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S MAIN ST",
            "city": "MILFORD",
            "state": "IN",
            "postal_code": "465423004",
            "telephone_number": "574-658-4142",
            "fax_number": "574-658-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S MAIN ST",
            "city": "MILFORD",
            "state": "IN",
            "postal_code": "465423004",
            "telephone_number": "574-658-4142",
            "fax_number": "574-658-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "REBECCA",
        "middle_name": "J.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02002877A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rebecca.johnson@goshenhealthdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "201 S Main St",
            "city": "Milford",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465423004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milford, IN

Sources for this page

Verify at the official NPI Registry.