NPIMap

Individual provider Active NPI

Emily Lou Johnson, PA-C

  • Physician Assistant
  • Maple Grove, MN
National Provider Identifier
1013309715
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11759 Issued in MN
Practice address
9630 Grove Cir N Ste 200
Maple Grove, MN 55369-3492
Phone
(763) 520-7870
Fax
(763) 520-7580
NPI assigned
Mar 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11759 MN Primary

Addresses

Primary practice location

9630 Grove Cir N Ste 200
Maple Grove, MN 55369-3492

Mailing address

4200 Dahlberg Dr Ste 300
Golden Valley, MN 55422-4841
Phone (952) 512-5600

Other names 1

  • Emily Lou Campbell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150414000678 MN Practitioner - Physician Assistant 0941528467 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Minnesota PhysiciansGroup PAC ID 9830001189, 158 clinicians

Practice addresses (Care Compare)

1900 Centracare Cir
Suite 2650
Saint Cloud, MN 56303-5000
Phone (320) 253-2663

720 Washington Ave SE
Minneapolis, MN 55414-2924
Phone (612) 884-0649

Hospital & facility affiliations

  • Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036
  • Centracare Health - Monticello Hospital, Monticello, MN, CCN 241362

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

Merit-based Incentive Payment System (MIPS)

Final score
86.67 of 100Reported as group
Quality
67.02
Promoting interoperability
99
Improvement activities
40
Cost
73.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
11759MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Regional Medical Center CurrentSince Nov 13, 2017 Accepting new patients
University of Minnesota Physicians CurrentSince Jan 2, 2024 Accepting new patients
Fairview Express Care CurrentSince Jan 2, 2024 Accepting new patients
University of Minnesota Physicians CurrentSince Jan 2, 2024 Accepting new patients
Fairview Express Care CurrentSince Jan 2, 2024 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jan 2, 2024 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jan 2, 2024 Accepting new patients
St. Francis Regional Medical Center CurrentSince Nov 13, 2017 Accepting new patients
Fairview Health Services Past Accepting new patients
University of Minnesota Physicians Past Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients
Cardiothoracic Surgery Clinic of North Ms Past Accepting new patients

Locations

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

1900 Centracare Cir
Ste 500
Saint Cloud, MN 56303
Phone (320) 229-5099

Interoperability endpoints

  • Direct secure messaging: ejohnson771107@direct.centracare.com

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 13

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1425427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1013309715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 DAHLBERG DR STE 300",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224841",
            "telephone_number": "952-512-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9630 GROVE CIR N STE 200",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553693492",
            "telephone_number": "763-520-7870",
            "fax_number": "763-520-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EMILY",
        "middle_name": "LOU",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-04",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "CAMPBELL",
            "middle_name": "LOU",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.