Individual provider Active NPI

Jessica Johnson, MD, MPH

  • Family Medicine Physician
  • Woonsocket, RI
National Provider Identifier
1679831937
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD15987 Issued in RI
Practice address
450 Clinton St
Woonsocket, RI 02895-3207
Phone
(401) 767-4100
NPI assigned
Apr 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD164793 OR
Family Medicine Physician 207Q00000X MD15987 RI Primary

Addresses

Primary practice location

450 Clinton St
Woonsocket, RI 02895-3207

Mailing address

450 Clinton St
Woonsocket, RI 02895-3207
Phone (401) 767-4100

Other practice location 1

115 Cass Ave
Woonsocket, RI 02895-4705
Phone (401) 769-4100

Other practice location 2

101 Dudley St
Providence, RI 02905-2499
Phone (401) 274-1100

Other identifiers 1

IdentifierTypeStateIssuer
1679831937MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160722000574 IL Practitioner - Family Practice 9739198664 Reassigns benefits to 1 organization
I20170923000484 RI Practitioner - Family Practice 9739198664 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Connecticut School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thundermist Health CenterGroup PAC ID 1557270477, 161 clinicians

Practice addresses (Care Compare)

450 Clinton St
Woonsocket, RI 02895-3207
Phone (401) 767-4100

Hospital & facility affiliations

  • The Miriam Hospital Hospital, Providence, RI, CCN 410012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD15987RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thundermist Health Center CurrentSince Aug 28, 2017 Accepting new patients
PCC Community Wellness Center CurrentSince Jul 14, 2016 Accepting new patients
Thundermist Health Center CurrentSince Aug 28, 2017 Accepting new patients
Prime Healthcare Services Landmark LLC CurrentSince Jan 13, 2022 Accepting new patients
PCC Community Wellness Center CurrentSince Jul 14, 2016 Accepting new patients
Prime Healthcare Services Landmark LLC Family Medicine CurrentSince Jan 13, 2022 Accepting new patients
Thundermist Health Center Past Accepting new patients

Locations

5425 W Lake St
Chicago, IL 60644
Phone (773) 378-3347

14 Lake St
Oak Park, IL 60302
Phone (708) 383-0113

206 Cass Ave
Woonsocket, RI 02895
Phone (401) 597-5070

450 Clinton St
Woonsocket, RI 02895

115 Cass Ave
Woonsocket, RI 02895
Phone (401) 356-1701

25 John a Cummings Way
Ste 302
Woonsocket, RI 02895

Interoperability endpoints

  • Direct secure messaging: jessica.johnson@thundermist.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/DCBEAA

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 1

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": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1679831937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLINTON ST",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953207",
            "telephone_number": "401-767-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLINTON ST",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953207",
            "telephone_number": "401-767-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Cass Ave",
            "address_purpose": "LOCATION",
            "city": "Woonsocket",
            "state": "RI",
            "postal_code": "028954705",
            "country_code": "US",
            "telephone_number": "401-769-4100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Dudley St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029052499",
            "country_code": "US",
            "telephone_number": "401-274-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-24",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD164793",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD15987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679831937",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

Verify at the official NPI Registry.