DR. DWAYNE EDWARD JOHNSON M.D.
NPI 1841379187
Pediatrics in Elkhart, IN

Q: What is Dwayne Johnson's NPI number?

The NPI number for Dwayne Johnson is 1841379187. It was assigned to this individual provider in the NPPES registry on November 6, 2006.

Q: What is Dwayne Johnson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Dwayne Johnson was last updated on November 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 06, 2006PECOS Enrolled

236 SIMPSON AVE, ELKHART, IN 46516(574) 584-7373(574) 293-3744 Get Directions Write a Review

NPPES record last updated: November 3, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 3, 2023, Mar 2, 2017 (2 updates tracked since 2017).

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About Dr. Dwayne Edward Johnson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DWAYNE EDWARD JOHNSON M.D. (NPI 1841379187) is an individual pediatrics provider in Elkhart, Indiana, licensed in Indiana (01073977A) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Kentucky College Of Medicine (1983).

NPPES Registry Identity

NPI1841379187

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameDR. DWAYNE EDWARD JOHNSONCredential: M.D.

Location Address236 SIMPSON AVEElkhart, IN 46516-4666

Mailing Address148 W Hively Ave, Suite 1Elkhart, IN 46517-2191 · (574) 350-2500 · Fax (574) 350-2598

Phone(574) 584-7373

Fax(574) 293-3744

Sole ProprietorYes

Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 1983

Enumeration DateNovember 6, 2006

Last NPPES UpdateNovember 3, 20232 updates tracked since enumeration

NPPES CertifiedNovember 3, 2023

✔ NPI 1841379187 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Licenses✔ Licensed in IN · 01073977A✔ Licensed in KY · 28666

Definition

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.

236 SIMPSON AVE, Elkhart, IN 46516

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Other Identifiers 14

Other611336483Commonwealth Health Allia

Other611336483Mail Handlers Benefit Pla

Other611336483Pponext

Medicaid642886669KY

Medicaid200287610BIN

Other611336483United Healthcare

Other2435769000Passport Advantage

Other611336483Humana Health Plan, Inc.

Other1087687Passport Health Plan

Other611336483Preferred Health Plan

Other000000052119Anthem

Other2133380Aetna

Other6113364834most Health Network

Other87043First Health Network

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Dwayne Edward Johnson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5890283121

PECOS Enrollment IDI20251020001719

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46516 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEART CITY HEALTH CENTER PHARMACY

Clinic/Center (Community Health)