Lori Sue Johnson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704166647 Issued in MI

Practice address

275 Michigan St NE
Grand Rapids, MI 49503-2531

Phone

(616) 391-5272

Fax

(616) 391-9010

NPI assigned

Dec 20, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Lori Sue Gale Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MI

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Spectrum Health HospitalsGroup PAC ID 8921904764, 161 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
• Spectrum Health United Hospital Hospital, Greenville, MI, CCN 230035
• Corewell Health Pennock Hospital Hospital, Hastings, MI, CCN 231339

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ljohnson51888@epic00.corewelldirect.org

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.

• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment Care Compare group NPD
• Spectrum Health Hospitals

  • Hospitalist Physician
  • Grand Rapids, MI
  • NPI 1558407189
  Medicare reassignment Care Compare group
• Newaygo County General Hospital Association

  • Hospitalist Physician
  • Fremont, MI
  • NPI 1750404927
  Medicare reassignment NPD
• Pennock Hospital

  • Family Medicine Physician
  • Hastings, MI
  • NPI 1518186295

  Nurse Practitioner

  Medicare reassignment NPD
• Newaygo County General Hospital Association

  • Critical Access Hospital
  • Fremont, MI
  • NPI 1063836963
  NPD
• Pennock Hospital

  • Internal Medicine Physician
  • Hastings, MI
  • NPI 1750500435
  NPD
• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667
  NPD

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

• Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Spectrum Health Hospitals

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation
• Spectrum Health United

  • General Acute Care Hospital
  • Greenville, MI
  • NPI 1457304495
  Care Compare affiliation

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1982110367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032531",
            "telephone_number": "616-391-5272",
            "fax_number": "616-391-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LORI",
        "middle_name": "SUE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-20",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704166647",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704166647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgale51888@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "221 Michigan St NE Ste 300",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032537",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "221 Michigan St NE Ste 300",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "GALE",
            "middle_name": "SUE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kory James Johnson, D.O.
• Kyra S Johnson, RDN
• Latasha Johnson
• Latisha Johnson
• Lisa Gifford Johnson, MSW
• Megan Elinor Johnson, BCBA
• Michael Johnson, PA-C
• Michael Thomas Johnson, M.D.
• Mikayla Grace Johnson, DPT
• Monica May Johnson, LMSW

• Family Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.