Individual provider Active NPI

Deborah Ruth Johnson, C.N.M.

  • Midwife
  • Bridgeport, CT
National Provider Identifier
1851440242
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
515 Issued in CT
Practice address
509 Park Ave
Bridgeport, CT 06604-5859
Phone
(203) 330-6000
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 309000231 IL
Midwife 176B00000X 515 CT Primary

Addresses

Primary practice location

509 Park Ave
Bridgeport, CT 06604-5859

Mailing address

46 Albion St
Bridgeport, CT 06605-2602
Phone (203) 330-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20221205001163 CT Practitioner - Certified Nurse Midwife (CNM) 7618346297 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
515CTMDClinical Psychologist
309000231ILMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
South-West Community Health Center, Inc CurrentSince Jul 12, 2022 Accepting new patients

Locations

46 Albion St
Bridgeport, CT 06605
Phone (203) 332-3155

510 Clinton Ave
Bridgeport, CT 06605
Phone (203) 366-4000

968 Fairfield Ave
Bridgeport, CT 06605

762 Lindley St
Bridgeport, CT 06606
Phone (203) 576-5131

Organizations & group practices 1

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1851440242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 ALBION ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066052602",
            "telephone_number": "203-330-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 PARK AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066045859",
            "telephone_number": "203-330-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEBORAH",
        "middle_name": "RUTH",
        "credential": "C.N.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "309000231",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CT",
            "license": "515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.