AMANDA C. JOHNSON (NPI# 1285995589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285995589 |
| Entity Type | Individual |
| Full Name | AMANDA C. JOHNSON |
| Credential | M.D. |
| Practice Address |
55 Lake Ave N Worcester MA 01655-0002 |
| Mailing Address |
Po Box 415348 Boston MA 02241-5348 |
| Practice Telephone | 7744422164 |
| Practice Fax Number | 7744432062 |
| Mailing Telephone | 8002258885 |
| Mailing Fax Number | 5083341977 |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2019-06-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
262592 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110099386A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366040826 | Amanda Johnson | Technician | 1401 S Seward Meridian Pkwy # Ab, Wasilla, AK 99654-8312 | 2020-10-15 |
| 1184221178 | Amanda Elisa Johnson | Registered Nurse | 36 Chadwick Mnr, Fairport, NY 14450-8820 | 2020-10-03 |
| 1487263422 | Amanda Johnson | Nurse Practitioner | 1112 N Main Ave, Erwin, TN 37650-1508 | 2020-07-27 |
| 1922579234 | Amanda Johnson | Social Worker | 701 Zellwood Cir, Talladega, AL 35160 | 2018-12-12 |
| 1275022279 | Amanda Johnson | Chiropractor | 14555 E Arapahoe Rd Unit B, Aurora, CO 80016-1584 | 2018-05-04 |
| 1215438031 | Amanda D Johnson | Licensed Practical Nurse | 501 Fletcher Ave Apt 12, Lincoln, NE 68521-1364 | 2018-02-27 |
| 1508374174 | Amanda L Johnson | Nurse Practitioner | 108 Brenray Dr, Harriman, TN 37748-5148 | 2018-01-17 |
| 1063935807 | Amanda Nicole Johnson | Home Health Aide | 5831 Ravenna Ave, Louisville, OH 44641-9216 | 2017-07-24 |
| 1174058283 | Amanda Johnson | Counselor | 8370 Us Highway 82 E, Sherman, TX 75090-2404 | 2017-04-26 |
| 1023556255 | Amanda Johnson | Community Based Residential Treatment Facility, Mental Illness | 1442 Valota Rd, Redwood City, CA 94061-2620 | 2017-02-08 |
| Street Address |
55 LAKE AVE N |
| City | WORCESTER |
| State | MA |
| Zip Code | 01655-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556587 | James E Liebmann | Internal Medicine | 55 Lake Ave N, Hematology/oncology, Worcester, MA 01655-0002 | 2005-05-23 |
| 1518568732 | Justin Bullard | Psychologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-11-04 |
| 1346849825 | Meghan Moore | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-26 |
| 1174122899 | Jessica Goncalves Ferreira | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-23 |
| 1235746686 | Desiree Mytych | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-29 |
| 1659986248 | Rebecca Lynn Harris | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-10 |
| 1639781487 | Gabriella Kathleen Holland | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-21 |
| 1730791898 | Kerry Anne Benedict | Speech-Language Pathologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1902418999 | Natasha R. Turner | Genetic Counselor, MS | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1144830712 | Abbey Corsini | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205489713 | Darryl Sweeper Jr. | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Psychiatry, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-23 |
| 1225690530 | Ryan Zenevitch | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Family Medicine, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-08 |
| 1932688454 | Victoria Sayeg | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Pediatrics, Worcester, MA 01655 | 2018-08-07 |
| 1114425675 | Judith Dio Wentzell | Social Worker | Umassmemorial Medical Center, 55 Lake Ave North, Dept of Care Coordination, Worcester, MA 01655 | 2018-01-30 |
| 1861927386 | Muhammad Waqas Khan | Student in an Organized Health Care Education/Training Program | University of Massachusetts 55 North Lake Ave, Neurology, Worcester, MA 01655 | 2017-04-21 |
| 1861806192 | Qaiser Shamshir Khan | Psychiatry & Neurology | 55 Lake Ave N # S7-831, Worcester, MA 01655 | 2014-06-14 |
| 1073858981 | Heidi Glover | Nurse Practitioner | 55 Lake Ave North Dept. of Pedi-adolescent, Ummc University Campus, Worcester, MA 01655 | 2012-12-04 |
| 1972867992 | Anna Bjornsdottir | Psychiatry & Neurology | 55 Lake Av N, Worcester, MA 01655 | 2012-06-25 |
| 1245567676 | Steven Edward Mckinley | Nurse Practitioner | 55 Lake Ave. North, Umass Memorial Medical Center University Campus, Worcester, MA 01655 | 2009-11-05 |
| 1851582951 | Robin I Davidson | Neurological Surgery | 55 Lake Ave, North, Ummhc-univ Campus, Worcester, MA 01655 | 2007-08-05 |
| Find all providers in zip 01655 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326699935 | Colin Meyer-macaulay | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2019-09-25 |
| 1902303480 | Haley Devries | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2018-04-10 |
| 1194272013 | Cheuk Chung Au | Pediatrics | 300 Longwood Ave, Bader 634, Boston, MA 02115-5724 | 2016-09-08 |
| 1669896775 | Pallav Bhattarai | Pediatrics | 759 Chestnut Street, Springfield, MA 01107-1619 | 2014-02-10 |
| 1215378435 | Peta-maree Ann Alexander | Pediatrics | Boston Children's Hospital, 300 Longwood Avenue, Cardiology Department, Boston, MA 02115 | 2013-07-16 |
| 1013352277 | Sarah Elyse Hendrickson | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2013-05-01 |
| 1841556305 | Jane Whitney | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2012-04-09 |
| 1891061768 | Jennifer Ann Blumenthal | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2012-03-26 |
| 1679848782 | Daniel Hames | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2012-03-22 |
| 1912297045 | Ben D Albert | Pediatrics | 300 Longwood Ave, Bader 634 - Critical Care Medicine, Boston, MA 02115-5724 | 2011-04-11 |
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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.