Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Stacey Johnston, MD

Individual provider Family Medicine Physician · NPI 1144414368

Dr. Stacey Johnston, MD is a Family Practice in South Bend, Indiana. Graduated from Emory University School of Medicine in 2002, 24 years ago. Works from 2 locations and accepts Medicare assignment. Licensed in Florida, Georgia and Indiana.

Years since qualifying
24
Trained at
Emory University School of Medicine
Licensed in
FL, GA, IN
In the registry since
2007
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

615 N Michigan St Fl 1
South Bend, IN 46601-1033
Phone: (574) 647-3050
Fax: (574) 647-1094
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 820 Prudential Dr Ste 304, Jacksonville, FL 32207 — (904) 202-3860

Specialties & licences

Hospitalist Physician (primary) Taxonomy 208M00000X · Licence ME137361 (FL)
Family Medicine Physician Taxonomy 207Q00000X · Licence ME137361 (FL)
Family Medicine Physician Taxonomy 207Q00000X · Licence 01096098A (IN)
Family Medicine Physician Taxonomy 207Q00000X · Licence 001842 (GA)

Record details

NPI number1144414368
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 30, 2007
Last updated in NPPESNovember 7, 2025
Certification dateNovember 7, 2025
Mailing address3245 Health Dr Ste 100, Granger, IN 46530-1380

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolEMORY UNIVERSITY SCHOOL OF MEDICINE
Graduated 2002 (24 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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