HEATHER JOHNSON (NPI# 1366656449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366656449 |
| Entity Type | Individual |
| Full Name | HEATHER JOHNSON |
| Credential | P.A. |
| Practice Address |
990 W Ann Arbor Trl Plymouth MI 48170-6204 |
| Practice Telephone | 7344141099 |
| Practice Fax Number | 7344141065 |
| Mailing Telephone | 7344141099 |
| Mailing Fax Number | 7344141065 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601004334 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | LICENSE | 5601004334 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023621760 | Heather Nicole Johnson | Nurse Practitioner | 13486 Springhill Ct Apt Suite, Winnebago, IL 61088-8054 | 2020-08-24 |
| 1417596685 | Heather Johnson | Social Worker | 1815 Crescent Dr, Champaign, IL 61821-5829 | 2020-01-05 |
| 1538633284 | Heather Allison Johnson | Registered Nurse | 1009 Terry Ranch Rd, Cheyenne, WY 82007-9708 | 2019-01-16 |
| 1457820706 | Heather Blythe Johnson | Occupational Therapy Assistant | 15620 Opal Fire Dr, Austin, TX 78728-3655 | 2018-11-15 |
| 1235605270 | Heather Renee Johnson | Nurse Practitioner | 6699 Corte Maria, Carlsbad, CA 92009-5917 | 2018-10-17 |
| 1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
| 1275049249 | Heather Rose Johnson | Early Intervention Provider Agency | 166 Centre Ave, Middleboro, MA 02346-2053 | 2017-12-28 |
| 1508387937 | Heather A Johnson | Massage Therapist | 3041 Aldrich Ave S, Minneapolis, MN 55408-2802 | 2017-07-06 |
| 1700251246 | Heather Johnson | Behavioral Analyst | 390 Mac Arthur Blvd, Hauppauge, NY 11788-3057 | 2015-12-09 |
| 1467834978 | Heather Lee Johnson | Registered Nurse | 2406 Buckhorn Ave, Schofield, WI 54476-5145 | 2015-06-19 |
| Street Address |
990 W ANN ARBOR TRL |
| City | PLYMOUTH |
| State | MI |
| Zip Code | 48170-6204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629075577 | Christine Stankovic | Pediatrics | 990 W Ann Arbor Trl, Suite 210, Plymouth, MI 48170-6204 | 2005-07-07 |
| 1437608965 | Tara Valentine | Nurse Practitioner | 990 W Ann Arbor Trl, Suite 210, Plymouth, MI 48170-6204 | 2016-09-26 |
| 1780027805 | Craig Steven Gertner | Internal Medicine | 990 W Ann Arbor Trl, Suite 208, Plymouth, MI 48170-6204 | 2013-04-08 |
| 1922345107 | Praveen Modi, M.d., P.C. | Internal Medicine | 990 W Ann Arbor Trl, Suite 102, Plymouth, MI 48170-6204 | 2013-01-09 |
| 1285998377 | Jeffrey Vanhooser | Internal Medicine | 990 W Ann Arbor Trl, Suite 208, Plymouth, MI 48170-6204 | 2012-07-03 |
| 1437410263 | Matthew A Kohlenberg | Internal Medicine | 990 W Ann Arbor Trl, Suite 208, Plymouth, MI 48170-6204 | 2012-06-07 |
| 1730455569 | Ashley Ann Schmehl | Internal Medicine | 990 W Ann Arbor Trl, Ste 208, Plymouth, MI 48170-6204 | 2012-03-27 |
| 1992095467 | Stephanie Jill Donovan | Podiatrist | 990 W Ann Arbor Trl, Suite 200, Plymouth, MI 48170-6204 | 2011-04-18 |
| 1912206368 | Lisa Odaibo | Pediatrics | 990 W Ann Arbor Trl, Ste 210, Plymouth, MI 48170-6204 | 2011-03-24 |
| 1447566559 | Sondra Raubacher | Nurse Practitioner | 990 W Ann Arbor Trl, Suite 210, Plymouth, MI 48170-6204 | 2010-08-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720611734 | Brightside Medical of Michigan, P.C. | Psychiatry & Neurology | Telemedicine Services Only / No Physical Office, Telemedicine Services Only / No Physical, MI 48170 | 2020-02-18 |
| 1265075279 | Mast Enterprises | Home Health | 40800 Five Mile Rd Ste C, Plymouth, MI 48170 | 2019-10-22 |
| 1003470964 | Smiley Private Homecare LLC | Technician, Pathology | 1098 Ann Arbor Rd #249, Plymouth, MI 48170 | 2019-04-26 |
| 1275003832 | Atsalis Dental Excellence | Dentist | 690 South Main St, Plymouth, MI 48170 | 2018-11-27 |
| 1275003808 | Danielle Cefalo | Speech-Language Pathologist | 801 W. Ann Arbor Trail Suite 220, Plymouth, MI 48170 | 2018-11-27 |
| 1962987966 | Mindful Wellness Counseling, LLC | Social Worker | 9266 Northern Ave, Plymouth, MI 48170 | 2018-09-26 |
| 1972094027 | Plymouth Urgent Care Walk-in Clinic LLC | Clinic/Center | 1498 S Sheldon Rd, Plymouth, MI 48170 | 2018-05-24 |
| 1356843791 | Polaris Pharmacy Services of Michigan, LLC | Pharmacy | 9131 General Court, Plymouth, MI 48170 | 2018-03-01 |
| 1528569787 | Alcona Citizens for Health Inc | Clinic/Center | 101 S Union St Unit 101, Plymouth, MI 48170 | 2018-02-23 |
| 1073029484 | Holly Ann Haase | Technician/Technologist | 650 Church St, Plymouth, MI 48170 | 2017-12-20 |
| Find all providers in zip 48170 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902371735 | Victoria Stark | Physician Assistant | 1498 S Sheldon Rd, Plymouth, MI 48170-2140 | 2018-10-08 |
| 1285184531 | Timothy Hurlburt | Physician Assistant | 30 Aldrin Rd, Plymouth, MA 02360-4804 | 2016-10-11 |
| 1336699875 | Timothy Hurlburt | Physician Assistant | 30 Aldrin Rd, Plymouth, MA 02360-4804 | 2016-10-07 |
| 1194004523 | Elizabeth Ashley Kozak | Physician Assistant | 15474 N Haggerty Rd, Plymouth, MI 48170-4893 | 2011-08-16 |
| 1821226440 | Jaime L Marani | Physician Assistant | 275 Sandwich St, Plymouth, MA 02360-2183 | 2009-06-23 |
| 1851534713 | David Brian Dickinson | Physician Assistant | 16 Hospital Rd, Plymouth, NH 03264 | 2009-04-08 |
| 1780754978 | Kenneth Joseph Ruemenapp | Physician Assistant | 14300 N Beck Rd, Plymouth, MI 48170-3377 | 2006-11-08 |
| 1033229596 | Brittania Mcdonald | Physician Assistant | 16 Hospital Road, Plymouth Ob/gyn, Plymouth, NH 03264 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616687 | Alexandria Jaclyn Miller | Physician Assistant | 4700 Chipman Dr, Waterford, MI 48327-3413 | 2020-10-15 |
| 1639777287 | Piotr Z Purzycki | Physician Assistant | 41400 Dequindre Rd Ste 101, Sterling Heights, MI 48314-3751 | 2020-10-15 |
| 1013524859 | Amber Marie Lee | Physician Assistant | 2265 South Lindenroad, Suite A, Flint, MI 48532 | 2020-09-25 |
| 1326656844 | Dominic Farrell | Physician Assistant | 224 Portchester Rd, Holland, MI 49424-2628 | 2020-07-21 |
| 1982212072 | Alexandria Bower-nelson | Physician Assistant | 1302 Porter Drive, Charlotte, MI 48813 | 2020-07-15 |
| 1013535343 | Maria Pavia | Physician Assistant | 41302 Scarborough Ln, Novi, MI 48375-2893 | 2020-07-13 |
| 1073130241 | Kelly F Esper | Physician Assistant | 9043 Glenwood Ln, Northville, MI 48168-9129 | 2020-07-02 |
| 1811513971 | Tasha Baker | Physician Assistant | 5444 E Whitefeather Rd, Pinconning, MI 48650-8407 | 2020-06-24 |
| 1437770054 | Sterling Ryan Maxfield | Physician Assistant | 6187 Oak Grove Rd, Howell, MI 48855-8247 | 2020-05-05 |
| 1760018808 | Rachel Renee Mackmin | Physician Assistant | 41498 Mary Kay Dr, Clinton Township, MI 48038-1989 | 2020-03-20 |
| Find all providers with the same taxonomy | ||||
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| 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.