Individual provider Active NPI

Annette Isom Johnson, CNM

  • Advanced Practice Midwife
  • Heber City, UT
National Provider Identifier
1871821496
Registry record updated Jul 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
263590-4402 Issued in UT
Practice address
30 E 3000 S
Heber City, UT 84032-3646
Phone
(435) 657-0945
NPI assigned
Nov 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2010

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 263590-4402 UT Primary

Addresses

Primary practice location

30 E 3000 S
Heber City, UT 84032-3646

Mailing address

30 E 3000 S
Heber City, UT 84032-3646
Phone (435) 657-0945

Other names 1

  • Annette Johnson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20100817001038 UT Practitioner - Certified Nurse Midwife (CNM) 4486788197 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1105 W 1000
Salt Lake City, UT 84116-2135
Phone (801) 364-2434

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jul 22, 2012 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
University of Utah Adult Services CurrentSince Feb 1, 2015 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Ihc Health Services Inc CurrentSince Jul 22, 2012 Accepting new patients
University of Utah Adult Services CurrentSince Feb 1, 2015 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

900 Round Valley Dr
Ste 200
Park City, UT 84060
Phone (435) 658-7246

5121 S Cottonwood St
Ste 170
Salt Lake City, UT 84107
Phone (801) 507-7070

370 Ninth Ave
Ste 101
Slc, UT 84103
Phone (801) 408-2999

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

5373 W Lake Park Blvd
West Valley City, UT 84120
Phone (801) 902-7940

Organizations & group practices 7

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": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1871821496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E 3000 S",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840323646",
            "telephone_number": "435-657-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E 3000 S",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840323646",
            "telephone_number": "435-657-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANNETTE",
        "middle_name": "ISOM",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-19",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "UT",
            "license": "263590-4402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNETTE",
            "last_name": "JOHNSON",
            "credential": "CNM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Heber City, UT

Sources for this page

Verify at the official NPI Registry.