Individual provider Active NPI

Emily Johnson, NP

  • Family Nurse Practitioner
  • Ypsilanti, MI
National Provider Identifier
1679026892
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F06161957 Issued in MI
Practice address
111 N Huron St Ste 200
Ypsilanti, MI 48197-2676
Phone
(734) 547-7977
Fax
(734) 572-4855
NPI assigned
Jul 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F06161957 MI Primary
Registered Nurse 163W00000X 4704301068 MI

Addresses

Primary practice location

111 N Huron St Ste 200
Ypsilanti, MI 48197-2676

Mailing address

PO Box 446
Ann Arbor, MI 48106-0446
Phone (734) 747-6766

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161025001599 MI Practitioner - Nurse Practitioner 2769760800 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704301068MIMDRegistered Nurse
F06161957MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Transitional Care Services, LLC CurrentSince Jul 22, 2024 Accepting new patients

Locations

5758 Cooley Lake Rd
Waterford, MI 48327
Phone (855) 466-3631

4568 W Walton Blvd
Ste D
Waterford Township, MI 48329
Phone (855) 466-3631

Interoperability endpoints

  • Direct secure messaging: emily.johnson.1@31855.direct.athenahealth.com

Organizations & group practices 1

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": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1679026892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 446",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481060446",
            "telephone_number": "734-747-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N HURON ST STE 200",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481972676",
            "telephone_number": "734-547-7977",
            "fax_number": "734-572-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EMILY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "F06161957",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704301068",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.