Individual provider Active NPI

Tina M Johnson, CNM

  • Advanced Practice Midwife
  • Springfield, MA
National Provider Identifier
1811901952
Registry record updated Dec 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN167829 Issued in MA
Practice address
3300 Main Street
Suite 4D
Springfield, MA 01107-1112
Phone
(413) 794-8336
Fax
(413) 794-7345
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2017

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 RN167829 MA Primary

Addresses

Primary practice location

3300 Main Street
Suite 4D
Springfield, MA 01107-1112

Mailing address

280 Chestnut St
2ND FL
Springfield, MA 01199-1001
Phone (413) 794-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050307000316 MA Practitioner - Certified Nurse Midwife (CNM) 4688628258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

280 Chestnut St
Suite 2
Springfield, MA 01199-1001

759 Chestnut St
Springfield, MA 01199-1001
Phone (413) 794-5439

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baystate Medical Practices, Inc CurrentSince Aug 27, 2012 Accepting new patients
Mercy Inpatient Medical Associates Inc. Advanced Practice Midwife PastSince Aug 17, 2020 Accepting new patients
Riverbend Medical Group, Inc Past Accepting new patients
Diversified Community Services Advanced Practice Midwife Past Accepting new patients

Locations

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385

3300 Main St
Springfield, MA 01199
Phone (413) 794-7035

233 Carew St
#101
Springfield, MA 01104
Phone (413) 748-9212

3300 Main St
Ste 4D
Springfield, MA 01107
Phone (413) 794-8336

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.

Hospital & facility affiliations 2

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513900800000",
    "number": "1811901952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST",
            "address_2": "2ND FL",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 MAIN STREET",
            "address_2": "SUITE 4D",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071112",
            "telephone_number": "413-794-8336",
            "fax_number": "413-794-7345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TINA",
        "middle_name": "M",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2017-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "RN167829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.