Individual provider Active NPI

Emily Jane Johnson, M.D.

  • Family Medicine Physician
  • Washington Court House, OH
National Provider Identifier
1659545945
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
89764 Issued in OH
Practice address
1510 Columbus Ave
Suite 230
Washington Court House, OH 43160
Phone
(740) 333-3333
Fax
(740) 333-5171
NPI assigned
Apr 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 89764 OH Primary

Addresses

Primary practice location

1510 Columbus Ave
Suite 230
Washington Court House, OH 43160

Mailing address

1450 Columbus Ave
Suite 104
Washington Court House, OH 43160-3701
Phone (740) 333-2236

Other identifiers 1

IdentifierTypeStateIssuer
2852328MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address emilyjohnson@fcmhms.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20080707000441 OH Practitioner - Family Practice 7315019494 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89764OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adena Medical Group LLC Family Medicine CurrentSince May 2, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

1450 Columbus Ave
Ste 103
Wshngtn Ct Hs, OH 43160
Phone (740) 333-2243

1450 Columbus Ave
Wshngtn Ct Hs, OH 43160
Phone (740) 335-2654

1450 Columbus Ave
Ste 104
Wshngtn Ct Hs, OH 43160
Phone (740) 333-2236

1510 Columbus Ave
Ste 230
Wshngtn Ct Hs, OH 43160
Phone (740) 333-3333

1450 Columbus Ave
Ste B
Wshngtn Ct Hs, OH 43160

1450 Columbus Ave
Ste 106
Wshngtn Ct Hs, OH 43160
Phone (614) 766-2006

Interoperability endpoints

  • Direct secure messaging: ejjohnson@yourcarecommunity.org
  • Direct secure messaging: ejohnson1060670@direct.osumc.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1659545945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 COLUMBUS AVE",
            "address_2": "SUITE 104",
            "city": "WASHINGTON COURT HOUSE",
            "state": "OH",
            "postal_code": "431603701",
            "telephone_number": "740-333-2236",
            "fax_number": "740-333-3881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 COLUMBUS AVE",
            "address_2": "SUITE 230",
            "city": "WASHINGTON COURT HOUSE",
            "state": "OH",
            "postal_code": "43160",
            "telephone_number": "740-333-3333",
            "fax_number": "740-333-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EMILY",
        "middle_name": "JANE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-17",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "89764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2852328",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emilyjohnson@fcmhms.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1510 Columbus Ave",
            "address_2": "Suite 230",
            "city": "Washington Court House",
            "state": "OH",
            "country_code": "US",
            "postal_code": "43160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Washington Court House, OH

Sources for this page

Verify at the official NPI Registry.