Annelyssa Nicole Johnson, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

DR.0056541 Issued in CO

Practice address

1701 N Senate Blvd # Ag012
Indianapolis, IN 46202-1239

Phone

(317) 962-3525

Fax

(317) 963-5394

NPI assigned

Apr 9, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CO, IN, IA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Emergency Medicine

Education

University of Arizona College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reid Physician Associates IncGroup PAC ID 6406910769, 427 clinicians

Trinity Regional Medical CenterGroup PAC ID 7315858529, 170 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Reid Health Hospital, Richmond, IN, CCN 150048
• Trinity Regional Medical Center Hospital, Fort Dodge, IA, CCN 160016

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ajohnson910929@direct.unitypoint.org
• Direct secure messaging: ajohnson328778@reidhealth.direct-ci.com
• Direct secure messaging: ajohnson328778@ecommunitydirect.com

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.

• Trinity Regional Medical Center

  • Emergency Medicine Physician
  • Fort Dodge, IA
  • NPI 1073594156
  Medicare reassignment Care Compare group NPD
• Reid Physician Associates, Inc.

  • Internal Medicine Physician
  • Richmond, IN
  • NPI 1265689111
  Medicare reassignment Care Compare group
• Usacs Community Emergency Services of Colorado, Inc.

  • Emergency Medicine Physician
  • Arvada, CO
  • NPI 1053824979
  Medicare reassignment NPD
• Usacs of Colorado, Inc

  • Emergency Medicine Physician
  • Littleton, CO
  • NPI 1760415871
  Medicare reassignment NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Usacs Community Emergency Services of Colorado, Inc.

  • Emergency Medicine Physician
  • Breckenridge, CO
  • NPI 1003549460
  NPD
• Usacs Community Emergency Services of Colorado, Inc.

  • Emergency Medicine Physician
  • Dacono, CO
  • NPI 1548895030
  NPD
• Usacs of Colorado Inc

  • Emergency Medicine Physician
  • Lakewood, CO
  • NPI 1720614217
  NPD

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

• Reid Hospital & Health Care Services, Inc

  • General Acute Care Hospital
  • Richmond, IN
  • NPI 1063457380
  Care Compare affiliation
• Trinity Regional Medical Center

  • General Acute Care Hospital
  • Fort Dodge, IA
  • NPI 1487759858
  Care Compare affiliation

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1609219682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 W VAN BUREN ST APT 1071",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850072575",
            "telephone_number": "520-406-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N SENATE BLVD # AG012",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "317-962-3525",
            "fax_number": "317-963-5394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANNELYSSA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR.0056541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajohnson328778@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "REID HOSPITAL & HEALTH CARE SERVICES, INC",
            "address_1": "1701 N Senate Blvd # Ag012",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajohnson328778@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "REID HOSPITAL & HEALTH CARE SERVICES, INC",
            "address_1": "1701 N Senate Blvd # Ag012",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy W Johnson, DO
• Andrew Joseph Johnson, PHARMD
• Angela Johnson, MD
• Angela Nicole Johnson
• Aniya Johnson
• Ashley Johnson
• Audrey Elizabeth Johnson, DDS
• Aysia C Johnson
• Barbara Claire Johnson
• Benetta E Johnson, PHD, HSPP

• Emergency Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; 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.
• 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.