DR. CHARISSE D JOHNSON (NPI# 1134399025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134399025 |
| Entity Type | Individual |
| Full Name | DR. CHARISSE D JOHNSON |
| Credential | MD |
| Practice Address |
100 Navarre Pl Ste 4440 South Bend IN 46601-1171 |
| Mailing Address |
16 Hospital Dr Ste D York ME 03909-1041 |
| Practice Telephone | 5746474540 |
| Practice Fax Number | 5746474542 |
| Mailing Telephone | 5746471610 |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2019-06-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 01068390A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200987950 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7150 Clearvista Dr, Indianapolis, IN 462561695 | 3176219650 | 3176217877 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306240338 | Charisse Johnson | Case Manager/Care Coordinator | 5221 Johnson St Apt 6, Fort Smith, AR 72904-4625 | 2014-10-20 |
| 1831229129 | Charisse Leshon Johnson | Pharmacist | 119 E 120th St, Chicago, IL 60628-6250 | 2007-03-06 |
| 1427605161 | Charisse Lashaune Johnson | Nurse Practitioner | 4105 Hospital St, Pascagoula, MS 39581-5312 | 2019-08-19 |
| Street Address |
100 NAVARRE PL STE 4440 |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46601-1171 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982691762 | Bryan Boyer | Orthopaedic Surgery | 100 Navarre Pl Ste 4440, South Bend, IN 46601-1171 | 2005-10-05 |
| 1801412085 | Katelyn J Yoder | Nurse Practitioner | 100 Navarre Pl Ste 4440, South Bend, IN 46601-1171 | 2020-06-23 |
| 1649736604 | Meghan M. Hart | Physician Assistant | 100 Navarre Pl Ste 4440, South Bend, IN 46601-1171 | 2019-02-14 |
| 1700303070 | Bethanie L Wrobleski | Nurse Practitioner | 100 Navarre Pl Ste 4440, South Bend, IN 46601-1171 | 2017-08-27 |
| 1225551591 | Melissa Demetriou | Nurse Practitioner | 100 Navarre Pl Ste 4440, South Bend, IN 46601-1171 | 2017-07-19 |
| 1285164285 | Allison Linea Hartman | Nurse Practitioner | 100 Navarre Pl Ste 4440, South Bend, IN 46601-1171 | 2017-06-13 |
| 1588014914 | Jeanna Geddes | Nurse Practitioner | 100 Navarre Pl Ste 4440, South Bend, IN 46601-1171 | 2016-06-16 |
| 1093000366 | Gregg M Ebersole | Orthopaedic Surgery | 100 Navarre Pl Ste 4440, South Bend, IN 46601-1171 | 2011-06-15 |
| 1407014442 | Joel M Post | Orthopaedic Surgery | 100 Navarre Pl Ste 4440, South Bend, IN 46601-1171 | 2008-05-27 |
| 1912112384 | Christiaan Nikolaje Mamczak | Orthopaedic Surgery | 100 Navarre Pl Ste 4440, South Bend, IN 46601-1171 | 2007-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447610449 | David Thomas | Hearing Instrument Specialist | 808 S Michigan St., South Bend, IN 46601 | 2016-03-03 |
| 1285072454 | Kevin Francis Cumper | Internal Medicine | 621 Memorial Dr Ste 624, South Bend, IN 46601 | 2013-06-11 |
| 1952605560 | Robert Lusk Bonham | Dentist | 1222 L.w.e., So. Bend, IN 46601 | 2010-12-23 |
| 1649580911 | Daniel Scott Debrule | Psychologist | 211 W. Washington Street, Suite 2311, South Bend, IN 46601 | 2010-10-20 |
| 1528390770 | Luke Alfred White | Internal Medicine | 615 N. Michigan St., Memorial Hospital, C/o Erin Smith, South Bend, IN 46601 | 2010-02-12 |
| 1548497837 | Tmg Home Health Care | Home Health | 108 N Main St #305, South Bend, IN 46601 | 2009-06-15 |
| 1225283039 | Jody L. Hughes | Counselor | 202 S. Michigan Street, Suite 875, South Bend, IN 46601 | 2008-11-20 |
| 1740432574 | Amanda Jayne Quicksall | Social Worker | 611 Lincolnway W, South Bend, IN 46601 | 2008-10-10 |
| 1952565772 | Thomas P Judd | Dentist | 1901 #b Western Avenue, Ihc South Bend, South Bend, IN 46601 | 2008-07-10 |
| 1851590269 | Warren Larry Penrod | Nurse Practitioner | 333 W. Western Ave, South Bend, IN 46601 | 2007-07-16 |
| Find all providers in zip 46601 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497399927 | Primary Care Partners of South Bend | Pediatrics | 300 S Saint Louis Blvd Ste 204, South Bend, IN 46617-3044 | 2019-10-28 |
| 1407282833 | Jill O Noreuil | Pediatrics | 50665 Ravenna Ct, South Bend, IN 46628-9634 | 2013-09-17 |
| 1255958310 | Vpa PC | Pediatrics | 5838 W Brick Rd Ste 106, South Bend, IN 46628-8420 | 2020-07-06 |
| 1720605884 | Vpa PC | Pediatrics | 5838 W Brick Rd Ste 106, South Bend, IN 46628-8420 | 2020-07-06 |
| 1760923023 | Javier Galan | Pediatrics | 211 N Eddy St, South Bend, IN 46617-2808 | 2017-03-19 |
| 1366820359 | Bradley Balint | Pediatrics | 615 N Michigan St Fl 5, South Bend, IN 46601-1033 | 2015-05-11 |
| 1720474620 | Sarah O'connor | Pediatrics | 615 N Michigan St Fl 5, South Bend, IN 46601-1033 | 2015-04-08 |
| 1215322052 | Melanie Lillian Leveille Leusink | Pediatrics | 615 N Michigan St Fl 5, South Bend, IN 46601 | 2015-03-30 |
| 1245658004 | Bernadette Lourdes O'neil | Pediatrics | 615 N Michigan St, South Bend, IN 46601-1033 | 2014-03-30 |
| 1285070284 | Alicia Marie Wilson | Pediatrics | 211 N Eddy St, South Bend, IN 46617-3096 | 2013-05-16 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46601 |
Please comment or provide details below to improve the information on DR. CHARISSE D JOHNSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.