DR. DWAYNE EDWARD JOHNSON M.D. NPI 1841379187

NPI Information

NPI: 1841379187
Provider Name: DR. DWAYNE EDWARD JOHNSON, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
236 SIMPSON AVE
ELKHART, IN
ZIP 46516
Phone: (574) 584-7373
Get Directions

DR. Dwayne Edward Johnson, M.D. is a pediatrics in Elkhart, IN. The provider is 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. DR. Dwayne Edward Johnson, M.D. NPI is 1841379187. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

236 SIMPSON AVE
ELKHART, IN
ZIP 46516-666
Phone: (574) 584-7373
Fax: (574) 293-3744

The enumeration date for this NPI number is 11/6/2006 and was last updated on 11/3/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		01073977A	INDIANA	Yes
2	208000000X	Pediatrics		28666	KENTUCKY	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	611336483	OTHER		COMMONWEALTH HEALTH ALLIA
2	611336483	OTHER		MAIL HANDLERS BENEFIT PLA
3	611336483	OTHER		PPONEXT
4	642886669	MEDICAID	KENTUCKY
5	200287610B	MEDICAID	INDIANA
6	611336483	OTHER		UNITED HEALTHCARE
7	2435769000	OTHER		PASSPORT ADVANTAGE
8	611336483	OTHER		HUMANA HEALTH PLAN, INC.
9	1087687	OTHER		PASSPORT HEALTH PLAN
10	611336483	OTHER		PREFERRED HEALTH PLAN
11	000000052119	OTHER		ANTHEM
12	2133380	OTHER		AETNA
13	611336483	OTHER		4MOST HEALTH NETWORK
14	87043	OTHER		FIRST HEALTH NETWORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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