Individual provider Active NPI

Katherine Michelle Johnson, D.O.

  • Obstetrics & Gynecology Physician
  • Grand Rapids, MI
National Provider Identifier
1619393899
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5101021006 Issued in MI
Practice address
221 Michigan St NE Ste 600
Grand Rapids, MI 49503-2540
Phone
(616) 774-7035
NPI assigned
Mar 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5101021006 MI Primary

Addresses

Primary practice location

221 Michigan St NE Ste 600
Grand Rapids, MI 49503-2540

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180809005097 MI Practitioner - Obstetrics/Gynecology 0042437774 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

221 Michigan St NE
600 Corewell Health Medical Group West
Grand Rapids, MI 49503-2540
Phone (616) 774-7035

4069 Lake Dr SE
Grand Rapids, MI 49546-8816

4249 Pkwy Place Dr SW C
Corewell Health Medical Group West
Grandville, MI 49418-2679
Phone (616) 774-7035

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101021006MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital Current Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 1, 2022 Accepting new patients
Spectrum Health Primary Care Partners Obstetrics & Gynecology CurrentSince Jul 1, 2022 Accepting new patients
Pathology Specialists of Southeast Michigan PC Current Accepting new patients
Henry Ford Health St. John Hospital Obstetrics & Gynecology CurrentSince Aug 1, 2018 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Aug 1, 2018 Accepting new patients
Spectrum Health Hospitals Past Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

221 Michigan St NE
Ste 600
Grand Rapids, MI 49503
Phone (616) 774-7035

221 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1405

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

4249 Parkway Place Dr SW
Grandville, MI 49418
Phone (616) 774-7035

4249 Parkway Place Dr SW
Ste C
Grandville, MI 49418
Phone (616) 774-7035

22151 Moross Rd
Ste 320
Grosse Pointe Woods, MI 48236
Phone (313) 343-4690

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

17900 23 Mile Rd
Ste 301
Macomb, MI 48044
Phone (586) 228-8874

29751 Little Mack Ave
Ste B
Roseville, MI 48066

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

Interoperability endpoints

  • Direct secure messaging: kjohnson477719@epic00.corewelldirect.org

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1394496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1619393899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 MICHIGAN ST NE STE 600",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032540",
            "telephone_number": "616-774-7035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHERINE",
        "middle_name": "MICHELLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101021006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.