NPIMap

Individual provider Active NPI

Valerie Lynn Johnson, MD

  • Internal Medicine Physician
  • Canton, MI
National Provider Identifier
1568441491
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
VJ053315 Issued in MI
Practice address
7330 N Canton Center Rd
Canton, MI 48187-1538
Phone
(734) 454-4001
NPI assigned
Jan 10, 2006
Last updated
Aug 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X VJ053315 MI Primary
Pediatrics Physician 208000000X VJ053315 MI

Addresses

Primary practice location

7330 N Canton Center Rd
Canton, MI 48187-1538

Mailing address

15500 Lundy Pkwy
Dearborn, MI 48126-2778
Phone (313) 586-5011

Other identifiers 1

IdentifierTypeStateIssuer
444718810MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100112000840 MI Practitioner - Internal MedicinePractitioner - Pediatric Medicine 1951315886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1988
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

15500 Lundy Pkwy
Dearborn, MI 48126-2778

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
VJ053315MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Ambulatory LLC Internal Medicine CurrentSince Apr 16, 2012 Accepting new patients
Oakwood Ambulatory, LLC CurrentSince Apr 16, 2012 Accepting new patients
William Beaumont Hospital Past Accepting new patients
Berkley Primary Care, PLC Internal Medicine PastSince Oct 1, 2002 Accepting new patients
Living Well Home Health Care, LLC Past Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

7330 N Canton Center Rd
Canton, MI 48187
Phone (734) 454-8001

29645 W 14 Mile Rd
Ste 110
Farmington Hills, MI 48334
Phone (248) 254-6000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDEEBA

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1568441491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15500 LUNDY PKWY",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262778",
            "telephone_number": "313-586-5011",
            "fax_number": "313-792-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 N CANTON CENTER RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481871538",
            "telephone_number": "734-454-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VALERIE",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "VJ053315",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "VJ053315",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "444718810",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.