NPIMap

Individual provider Active NPI

Molly Ann Johnson, M.D.

  • Obstetrics & Gynecology Physician
  • Grand Island, NE
National Provider Identifier
1750506911
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
24274 Issued in NE
Practice address
2444 W Faidley Ave
Grand Island, NE 68803-4327
Phone
(308) 382-1100
Fax
(308) 384-4306
NPI assigned
Apr 14, 2007
Last updated
Nov 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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 24274 NE Primary

Addresses

Primary practice location

2444 W Faidley Ave
Grand Island, NE 68803-4327

Mailing address

PO Box 550
Grand Island, NE 68802-0550
Phone (308) 382-1100

Other identifiers 4

IdentifierTypeStateIssuer
47017633016MedicaidNE
253308OtherNEMIDLANDS CHOICE
00121OtherNEBCBS
P00416267OtherNEPALMETTO GBA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070727000194 NE Practitioner - Obstetrics/Gynecology 9537260088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Nebraska College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Island Clinic IncGroup PAC ID 9931181526, 22 clinicians

Practice addresses (Care Compare)

2444 W Faidley Ave
Grand Island, NE 68803-4327
Phone (308) 382-1100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24274NEMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Island Clinic Inc Obstetrics & Gynecology CurrentSince Aug 13, 2007 Accepting new patients
Grand Island Clinic Inc Past Accepting new patients
Grand Island Regional Medical Center PastSince Feb 18, 2019 Accepting new patients
Grand Island Regional Medical Center Past Accepting new patients
Saint Francis Medical Center Past Accepting new patients

Locations

2444 W Faidley Ave
Grand Island, NE 68803
Phone (308) 382-1100

Interoperability endpoints

  • Direct secure messaging: mollyjohnson@gici.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Grand Island Regional Medical CenterGrand Island, NE, CCN 280139 Hospital Corporate Director Feb 18, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1176508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1750506911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688020550",
            "telephone_number": "308-382-1100",
            "fax_number": "308-385-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2444 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034327",
            "telephone_number": "308-382-1100",
            "fax_number": "308-384-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MOLLY",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-14",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NE",
            "license": "24274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47017633016",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "253308",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00121",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "P00416267",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.