Individual provider Active NPI

Jennifer L Johnson

  • Advanced Practice Midwife
  • Bowling Green, KY
National Provider Identifier
1780245118
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
350 Park St Ste 203
Bowling Green, KY 42101-1784
Phone
(270) 781-0075
NPI assigned
Jun 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X Primary

Addresses

Primary practice location

350 Park St Ste 203
Bowling Green, KY 42101-1784

Mailing address

1051 Chicory Way
Bowling Green, KY 42104-5616
Phone (605) 593-2953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190906001950 KY Practitioner - Certified Nurse Midwife (CNM) 7416286000 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Health Corporation, Inc Current Accepting new patients
Commonwealth Health Corporation, Inc. CurrentSince Jul 14, 2019 Accepting new patients
Commonwealth Health Corporation, Inc Advanced Practice Midwife CurrentSince Jul 14, 2019 Accepting new patients
Bowling Green Warren County Primary Care Center, Inc. Past Accepting new patients

Locations

350 Park St
Ste 203
Bowling Green, KY 42101
Phone (270) 781-0075

523 Park St
Bowling Green, KY 42101
Phone (270) 393-8418

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": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1780245118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 CHICORY WAY",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421045616",
            "telephone_number": "605-593-2953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 PARK ST STE 203",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011784",
            "telephone_number": "270-781-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.