Bruce M Johnson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

27883 Issued in MN

Practice address

205 S Wabasha St
Healthpartners St. Paul Clinic - Mail Stop 31300a
St. Paul, MN 55107-1805

Phone

(651) 293-8100

Fax

(651) 293-8106

NPI assigned

Mar 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Bruce M Johnson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1023077658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-883-5375",
            "fax_number": "651-293-8106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S WABASHA ST",
            "address_2": "HEALTHPARTNERS ST. PAUL CLINIC - MAIL STOP 31300A",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "551071805",
            "telephone_number": "651-293-8100",
            "fax_number": "651-293-8106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRUCE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "27883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRUCE",
            "last_name": "JOHNSON",
            "middle_name": "M",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Beth A Johnson, MD
• Brandon M Johnson, CRNA
• Bridget Marie Johnson, APRN, CNP
• Brienne Johnson
• Brooke Johnson, LADC
• Caleb Johnson
• Candace Rae Johnson, LICSW, LADC
• Chartiase M Johnson, LPN
• Chelsea Shirley Johnson, PA-C
• Christine Johnson

• Internal Medicine Physician in St. Paul, MN
• Providers in St. Paul, MN by specialty
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.