Active NPI
Liselle Marie Johnson, CNP
- Nurse Practitioner
- Rochester, MN
National Provider Identifier
1053719237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1577
- Practice address
- 200 1St St SW
Rochester, MN 55905-0001 - Phone
- (507) 284-2511
- NPI assigned
- Dec 19, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | CNP 1577 | MN | |
| Nurse Practitioner | 363L00000X | 1577 | MN | Primary |
Addresses
Primary practice location
200 1St St SW
Rochester, MN 55905-0001
Mailing address
701 Hewitt Blvd
Red Wing
MN, MN 55066-2848
Phone (507) 377-6285
Other practice location 1
32021 County 24 Blvd
Cannon Falls, MN 55009-5003
Phone (507) 263-6000
Other practice location 2
701 Hewitt Blvd
Red Wing, MN 55066-2848
Phone (507) 377-6285
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ljohnson87968@ehrdirect.mayoclinicmsg.org | ||
| Direct Messaging Address | ljohnson87968@ehrdirect.mayoclinicmsg.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
701 Hewitt Blvd
Red Wing, MN 55066-2848
Phone (651) 267-5000
Hospital & facility affiliations
- Mayo Clinic Health System in Red Wing
- Mayo Clinic Health System - Lake City
- Mayo Clinic Health System - Cannon Falls
- Mayo Clinic Hospital Rochester
- Allina United Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1577 | MN | MD | Nurse Practitioner |
| CNP 1577 | MN | MD | Family Nurse Practitioner |
Interoperability endpoints
- ljohnson87968@ehrdirect.mayoclinicmsg.org
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Albert Lea, MN
- NPI 1891701637
Hospital & facility affiliations 19
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Red Wing, MN
- NPI 1164400024
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- St Paul, MN
- NPI 1265474704
Hospital
-
- General Acute Care Hospital
- Saint Paul, MN
- NPI 1457319485
-
- General Acute Care Hospital
- Hastings, MN
- NPI 1508457045
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612224000000",
"number": "1053719237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 HEWITT BLVD",
"address_2": "RED WING",
"city": "MN",
"state": "MN",
"postal_code": "550662848",
"telephone_number": "507-377-6285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 1ST ST SW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559050001",
"telephone_number": "507-284-2511"
}
],
"practiceLocations": [
{
"address_1": "32021 County 24 Blvd",
"address_purpose": "LOCATION",
"city": "Cannon Falls",
"state": "MN",
"postal_code": "550095003",
"country_code": "US",
"telephone_number": "507-263-6000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "701 Hewitt Blvd",
"address_purpose": "LOCATION",
"city": "Red Wing",
"state": "MN",
"postal_code": "550662848",
"country_code": "US",
"telephone_number": "507-377-6285",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "LISELLE",
"middle_name": "MARIE",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-19",
"last_updated": "2021-02-02",
"certification_date": "2021-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MN",
"license": "CNP 1577",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "1577",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ljohnson87968@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "200 1st St SW",
"city": "Rochester",
"state": "MN",
"country_code": "US",
"postal_code": "559050001",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ljohnson87968@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "701 Hewitt Blvd",
"city": "Red Wing",
"state": "MN",
"country_code": "US",
"postal_code": "550662848",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.