Individual provider Active NPI

Lisa Anne Johnson, M.D.

  • Obstetrics & Gynecology Physician
  • Anchorage, AK
National Provider Identifier
1699875427
Registry record updated Oct 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
6033 Issued in AK
Practice address
3260 Providence Dr Ste 425
Anchorage, AK 99508-4603
Phone
(907) 561-7111
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 6033 AK Primary

Addresses

Primary practice location

3260 Providence Dr Ste 425
Anchorage, AK 99508-4603

Mailing address

3260 Providence Dr Ste 425
Anchorage, AK 99508-4603
Phone (907) 561-7111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20091111000480 AK Practitioner - Obstetrics/Gynecology 5496893455 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6033AKMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Alaska, P.C. Obstetrics & Gynecology CurrentSince May 30, 2015 Accepting new patients
Providence Health & Services Washington Past Accepting new patients
Planned Parenthood Great Northwest, Hawai'I, Alaska, Indiana, Kentucky Obstetrics & Gynecology PastSince Mar 9, 2016 Accepting new patients
Anchorage Women'S Clinic, LLC Obstetrics & Gynecology PastSince May 2, 2011 Accepting new patients

Locations

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

17101 Snowmobile Ln
Ste 201
Eagle River, AK 99577
Phone (907) 561-7111

Organizations & group practices 4

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256774400000",
    "number": "1699875427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 PROVIDENCE DR STE 425",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084603",
            "telephone_number": "907-561-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 PROVIDENCE DR STE 425",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084603",
            "telephone_number": "907-561-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2009-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AK",
            "license": "6033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.