Heather Johnson

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

209014879 Issued in IL

Practice address

611 S Marshall Ave
MC Leansboro, IL 62859-1213

Phone

(618) 643-2361

NPI assigned

Oct 12, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Heather Mitchell Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hamilton Memorial Hospital DistrictGroup PAC ID 6608865985, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health at Home Health-Illinois Home health agency, Mount Vernon, IL, CCN 147088
• Hamilton Memorial Hospital Hospital, McLeansboro, IL, CCN 141326
• Good Samaritan Regional HLTH Center Hospital, Mount Vernon, IL, CCN 140046

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hjohnson427871@direct-ehr-ssmhc.com
• FHIR API: https://fhir-usa.unify.chbase.com/org/hamilto-2525a05c

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.

• Hamilton Memorial Hospital District

  • Rural Health Clinic/Center
  • McLeansboro, IL
  • NPI 1609837665
  Medicare reassignment Care Compare group NPD
• Hamilton Memorial Hospital District

  • Rural Health Clinic/Center
  • Carmi, IL
  • NPI 1588902183
  NPD
• Hamilton Memorial Hospital District

  • Critical Access Hospital
  • MC Leansboro, IL
  • NPI 1447257258
  NPD (past)

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

• Good Samaritan Regional Health Center

  • General Acute Care Hospital
  • Mount Vernon, IL
  • NPI 1609897339
  Care Compare affiliation
• Hamilton Memorial Hospital District

  • Critical Access Hospital
  • MC Leansboro, IL
  • NPI 1447257258
  Care Compare affiliation
• Hamilton Memorial Hospital District

  • Rural Health Clinic/Center
  • Carmi, IL
  • NPI 1588902183

  Hospital

  Care Compare affiliation
• SSM Health Businesses

  • Home Health Agency
  • Mount Vernon, IL
  • NPI 1295798403
  Care Compare affiliation

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1841661287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 IL HIGHWAY 14",
            "city": "ENFIELD",
            "state": "IL",
            "postal_code": "628352314",
            "telephone_number": "618-384-8332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 S MARSHALL AVE",
            "city": "MC LEANSBORO",
            "state": "IL",
            "postal_code": "628591213",
            "telephone_number": "618-643-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-12",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71005773A",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71005773A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209014879",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209014879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "MITCHELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Acute Care Nurse Practitioner in MC Leansboro, IL
• Providers in MC Leansboro, IL by specialty
• Acute Care Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; 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.