Individual provider Active NPI

Jeffrey David Johnson, RN

  • Critical Care Medicine Registered Nurse
  • Spearfish, SD
National Provider Identifier
1043115744
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
R029066 Issued in SD
Practice address
1432 Woodburn Dr
Spearfish, SD 57783-1651
Phone
(605) 641-0520
NPI assigned
Oct 12, 2026
Last updated
Oct 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X R029066 SD Primary

Addresses

Primary practice location

1432 Woodburn Dr
Spearfish, SD 57783-1651

Mailing address

1432 Woodburn Dr
Spearfish, SD 57783-1651
Phone (605) 641-0520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1791763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791763200000",
    "number": "1043115744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1432 WOODBURN DR",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577831651",
            "telephone_number": "605-641-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 WOODBURN DR",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577831651",
            "telephone_number": "605-641-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEFFREY",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-12",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "SD",
            "license": "R029066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spearfish, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; 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.