Active NPI
Mary Johanna Johnson, M.D.
- Maternal & Fetal Medicine Physician
- Annapolis, MD
National Provider Identifier
1619990744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Maternal & Fetal Medicine Physician
- License
- D35702
- Practice address
- 185 Harry S Truman Pkwy Ste 120
Annapolis, MD 21401-7580 - Phone
- (410) 224-4442
- NPI assigned
- Jul 26, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Maternal & Fetal Medicine Physician | 207VM0101X | MD435925 | PA | |
| Maternal & Fetal Medicine Physician | 207VM0101X | D35702 | MD | Primary |
Addresses
Primary practice location
185 Harry S Truman Pkwy Ste 120
Annapolis, MD 21401-7580
Mailing address
PO Box 12622
Belfast, ME 04915-4017
Other identifiers 17
| Identifier | Type | State | Issuer |
|---|---|---|---|
| K4800009 | Other | MD | BCBS |
| 211641301 | Medicaid | MD | |
| 280835 | Other | PA | UNISON-YHCHC |
| 732204 | Other | MD | MEDICARE |
| 102246423 | Medicaid | PA | |
| 20086849 | Other | PA | AMERIHEALTH MERCY - WMG |
| 20091825 | Other | PA | AMERIHEALTH MERCY-YH |
| 211641300 | Medicaid | MD | |
| 400525 | Other | MD | CAREFIRST MD BCBS |
| 123846 | Other | PA | GEISINGER HEALTH PLAN |
| 20087483 | Other | PA | AMERIHEALTH MERCY-WMG |
| 261018 | Other | PA | UNISON-WMG |
| 30139634 | Other | PA | AMERIHEALTH MERCY-YHOBGYN |
| 701408 | Other | PA | HIGHMARK BLUE SHIELD |
| 019135 | Other | PA | JOHNS HOPKINS |
| 1578891 | Other | PA | GATEWAY-WMG |
| 50083119 | Other | PA | CAPITAL BLUE CROSS-WMG |
Other names 1
- Dr. Mary Johanna Gutberlet
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D35702 | MD | MD | Maternal & Fetal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Joseph Physician Enterprise | Past | Accepting new patients | |
| Saint Joseph Medical Center , Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Towson, MD
- NPI 1699862961
-
- Multi-Specialty Clinic/Center
- Towson, MD
- NPI 1518143304
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557100800000",
"number": "1619990744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12622",
"city": "BELFAST",
"state": "ME",
"postal_code": "049154017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 HARRY S TRUMAN PKWY STE 120",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214017580",
"telephone_number": "410-224-4442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MARY",
"middle_name": "JOHANNA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2019-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "207VM0101X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": "PA",
"license": "MD435925",
"primary": false
},
{
"code": "207VM0101X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": "MD",
"license": "D35702",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "K4800009",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "211641301",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON-YHCHC",
"identifier": "280835",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "732204",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102246423",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH MERCY - WMG",
"identifier": "20086849",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH MERCY-YH",
"identifier": "20091825",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "211641300",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST MD BCBS",
"identifier": "400525",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEISINGER HEALTH PLAN",
"identifier": "123846",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH MERCY-WMG",
"identifier": "20087483",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON-WMG",
"identifier": "261018",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH MERCY-YHOBGYN",
"identifier": "30139634",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "701408",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHNS HOPKINS",
"identifier": "019135",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY-WMG",
"identifier": "1578891",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS-WMG",
"identifier": "50083119",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "GUTBERLET",
"middle_name": "JOHANNA",
"prefix": "DR.",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Annapolis, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.