Jennifer L Johnson, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

R-11865 Issued in IA

Practice address

1111 6TH Ave
Des Moines, IA 50314-2613

Phone

(515) 643-2630

Fax

(515) 643-5802

NPI assigned

Jun 4, 2020

Last updated

Jun 4, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Detman Former name

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Psychiatry

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercyone Des Moines Medical Center Hospital, Des Moines, IA, CCN 160083

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjohnson3948520@direct.trinity-health.org

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.

• Mercy Clinics, Inc.

  dba MercyOne Clive Family Medicine Clinic

  • Primary Care Clinic/Center
  • Clive, IA
  • NPI 1487670923
  Medicare reassignment Care Compare group NPD
• Uhs Midwest Behavioral Health LLC

  • Psychiatry Physician
  • Clive, IA
  • NPI 1871174615
  Medicare reassignment NPD
• Mercy Clinics, Inc

  dba MercyOne Des Moines Psychiatry Hospitalists

  • Psychiatry Physician
  • Des Moines, IA
  • NPI 1861818163
  NPD
• Mercy Clinics, Inc.

  dba MercyOne Des Moines OB Hospitalists

  • Obstetrics & Gynecology Physician
  • Des Moines, IA
  • NPI 1508741505
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Catholic Health Initiatives - Iowa Corp

  dba MercyOne West Des Moines Medical Center

  • General Acute Care Hospital
  • West Des Moines, IA
  • NPI 1538395975
  Care Compare affiliation
• Catholic Health Initiatives-Iowa Corp

  dba MercyOne Des Moines Laboratory

  • Clinical Medical Laboratory
  • Des Moines, IA
  • NPI 1104982743

  Hospital

  Care Compare affiliation
• Catholic Health Initiatives-Iowa Corp

  dba MercyOne Des Moines Medical Center

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1508964883
  Care Compare affiliation
• Catholic Health Initiatives, Ia-Corp

  dba Mercy Medical Mammography Center

  • Mammography Clinic/Center
  • Des Moines, IA
  • NPI 1477984367

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1821612813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-643-2630",
            "fax_number": "515-643-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 6TH AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142613",
            "telephone_number": "515-643-2630",
            "fax_number": "515-643-5802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "R-11865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "DETMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heather Renee Johnson, RN, BSN
• Hilary Johnson
• Isaura Johnson
• Jack Alexander Johnson, PA-C
• Jay A Johnson, DO
• Jennifer Renee Johnson, RPH
• Jessica Brooke Johnson, DDS
• Joseph Thomas Johnson, DO
• Joy Lynn Johnson, OTR/L
• Julie Christine Johnson

• Psychiatry Physician in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Psychiatry Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.