Active NPI
Mary Therese Johnson, RN, APRN
- Family Nurse Practitioner
- Eau Claire, WI
National Provider Identifier
1518935717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2374-033
- Practice address
- 1221 Whipple St
Eau Claire, WI 54703-5270 - Phone
- (715) 552-5346
- NPI assigned
- Mar 14, 2006
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2374-033 | WI | Primary |
Addresses
Primary practice location
1221 Whipple St
Eau Claire, WI 54703-5270
Mailing address
PO Box 1185
Eau Claire, WI 54702-1185
Phone (715) 552-5346
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41195400 | Medicaid | WI |
Other names 1
- Mary T Bals
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | him@marshfieldclinichealthsystem.cernerdirect.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2374-033 | WI | MD | Family Nurse Practitioner |
Interoperability endpoints
- mary.johnson@marshfieldclinichealthsystem.cernerdirect.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617062400000",
"number": "1518935717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1185",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547021185",
"telephone_number": "715-552-5346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 WHIPPLE ST",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547035270",
"telephone_number": "715-552-5346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MARY",
"middle_name": "THERESE",
"name_prefix": "Ms.",
"credential": "RN, APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-14",
"last_updated": "2021-03-30",
"certification_date": "2021-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "2374-033",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41195400",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "1221 Whipple St",
"city": "Eau Claire",
"state": "WI",
"country_code": "US",
"postal_code": "547035270",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MARY",
"last_name": "BALS",
"middle_name": "T",
"credential": "RN, APRN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Eau Claire, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.