COLLEEN M. JOHNSON M.D. – NPI #1013216308
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.

COLLEEN JOHNSON is a physician located in KENOSHA, WI. NPPES has assigned the NPI number 1013216308 to COLLEEN JOHNSON on March 25, 2011. It is a Type-1 NPI, indicating this NPI number is associated with an individual. She is also known by her other name COLLEEN MARONEY-RUTTER. The primary taxonomy selected by this provider is 208000000X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics.

The NPI profile was previously updated about 4 years ago on Apr 20, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for COLLEEN JOHNSON below.

NPI Profile for
COLLEEN M. JOHNSON

NPI Number
1013216308
Enumeration Date

(more than 15 years ago)
Entity Type
Type-1  Individual (Female)
Legal Name
COLLEEN M. JOHNSON
Other Name: COLLEEN MARONEY-RUTTER
Credentials
M.D.
Primary location
8600 75TH ST STE 101
KENOSHA, WI 53142-8200
Phone: (262) 652-9430 Fax: (262) 652-9433
1 Other location(s):
5433 W Fond Du Lac Ave
Milwaukee, WI 53216-1382
Phone: (414) 277-8900
Fax: (414) 277-8939
Mailing address
9000 W WISCONSIN AVE
MAIL STATION 958
MILWAUKEE, WI 53226-4874
Phone: (414) 266-7615 Fax: (414) 266-6238
Sole Proprietor
No
Updated
Certification Date
Apr 20, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for COLLEEN JOHNSON

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDWI1013216308
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208000000X
- Pediatrics (Primary)
WI 60072-20

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.