Individual provider Active NPI

Lars Johann Johnson, MD

  • Pulmonary Disease Physician
  • Chicago, IL
National Provider Identifier
1619461928
Registry record updated Jul 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
036165458 Issued in IL
Practice address
420 E Superior St Ste 9-900
Chicago, IL 60611-4494
Phone
(312) 503-7975
NPI assigned
Jun 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036165458 IL
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 036165458 IL
Pulmonary Disease Physician 207RP1001X 036165458 IL Primary

Addresses

Primary practice location

420 E Superior St Ste 9-900
Chicago, IL 60611-4494

Mailing address

420 E Superior St Ste 9-900
Chicago, IL 60611-4494
Phone (312) 503-7975

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
I20210615002633 MI Practitioner - Internal MedicinePractitioner - Hospitalist 6800142803 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036165458ILMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Internal Medicine Current Accepting new patients
Iha Health Service Corporation CurrentSince Jul 1, 2021 Accepting new patients
Regents of the University of Michigan CurrentSince Jun 30, 2021 Accepting new patients
Iha Health Services Corporation CurrentSince Jul 1, 2021 Accepting new patients
Chelsea Community Hospital CurrentSince Mar 2, 2022 Accepting new patients
Regents of the University of Michigan Internal Medicine CurrentSince Jun 30, 2021 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Chelsea Community Hospital CurrentSince Mar 2, 2022 Accepting new patients

Locations

2215 Fuller Rd
Ann Arbor, MI 48105
Phone (734) 845-5290

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5301 E Huron River Dr
Fl 10
Ypsilanti, MI 48197
Phone (734) 712-8676

Interoperability endpoints

  • Direct secure messaging: ljohnson1057432@direct.trinity-health.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688774400000",
    "number": "1619461928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E SUPERIOR ST STE 9-900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114494",
            "telephone_number": "312-503-7975",
            "fax_number": "312-503-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E SUPERIOR ST STE 9-900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114494",
            "telephone_number": "312-503-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LARS",
        "middle_name": "JOHANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2023-07-08",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036165458",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036165458",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036165458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.