Individual provider Active NPI

Hannah Kara Johnson, M.D.

  • Pediatrics Physician
  • New Berlin, WI
National Provider Identifier
1689916801
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20391 Issued in WI
Practice address
4855 S Moorland Rd
New Berlin, WI 53151-7494
Phone
(262) 432-7599
Fax
(262) 432-7694
NPI assigned
Mar 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0438748 KS
Pediatrics Physician 208000000X 2016023059 MO
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 20391 WI Primary

Addresses

Primary practice location

4855 S Moorland Rd
New Berlin, WI 53151-7494

Mailing address

9000 W Wisconsin Ave # Ms 958
Milwaukee, WI 53226-4874
Phone (414) 266-7615

Other identifiers 1

IdentifierTypeStateIssuer
1689916801MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20160105000027 MO Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9830491174

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20391WIMDAddiction (Substance Use Disorder) Counselor
0438748KSMDPediatrics Physician
2016023059MOMDPediatrics Physician

Interoperability endpoints

  • Direct secure messaging: hjohnson84899@direct.chw.org

NPI Registry JSON

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1689916801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE # MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 S MOORLAND RD",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531517494",
            "telephone_number": "262-432-7599",
            "fax_number": "262-432-7694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HANNAH",
        "middle_name": "KARA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-26",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "0438748",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2016023059",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "20391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689916801",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Berlin, WI

Sources for this page

Verify at the official NPI Registry.