Individual provider Active NPI

Andrew I Johnson, D.C.

  • Chiropractor
  • Chesterton, IN
National Provider Identifier
1922161595
Registry record updated Feb 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001469A Issued in IN
Practice address
114 N Calumet Rd
Chesterton, IN 46304-2426
Phone
(219) 926-3310
Fax
(219) 926-3350
NPI assigned
Dec 18, 2006
Last updated
Feb 24, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001469A IN Primary

Addresses

Primary practice location

114 N Calumet Rd
Chesterton, IN 46304-2426

Mailing address

114 N Calumet Rd
Chesterton, IN 46304-2426
Phone (219) 926-3310

Other identifiers 2

IdentifierTypeStateIssuer
200898510AMedicaidIN
000000602635OtherINANTHEM PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080825000595 IN Practitioner - Chiropractic 1557436649 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08001469AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Northshore Health Centers Inc Current Accepting new patients
Northshore Health Centers, Inc. CurrentSince Jan 30, 2023 Accepting new patients
Northshore Health Centers, Inc. CurrentSince Jan 30, 2023 Accepting new patients
Northshore Health Centers, Inc. Past Accepting new patients

Locations

801 Broadway
Chesterton, IN 46304
Phone (219) 764-5311

310 W 112th Ave
Crown Point, IN 46307
Phone (219) 763-8113

1828 165th St
Ste A
Hammond, IN 46320
Phone (219) 764-5349

6050 Sterling Creek Rd
Portage, IN 46368
Phone (219) 212-0188

Interoperability endpoints

  • Direct secure messaging: andrew.johnson.p1@direct.northshorehealth.nextgenshare.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424736000000",
    "number": "1922161595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 N CALUMET RD",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463042426",
            "telephone_number": "219-926-3310",
            "fax_number": "219-926-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N CALUMET RD",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463042426",
            "telephone_number": "219-926-3310",
            "fax_number": "219-926-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDREW",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2015-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001469A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200898510A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000602635",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.