Active NPI
Karen Marie Johnson, PT
- Physical Therapist
- Cloquet, MN
National Provider Identifier
1053934877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 1204 Cloquet Ave
Cloquet, MN 55720-1622 - Phone
- (218) 878-0805
- Fax
- (218) 878-0794
- NPI assigned
- May 27, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
1204 Cloquet Ave
Cloquet, MN 55720-1622
Mailing address
1204 Cloquet Ave
Cloquet, MN 55720-1622
Phone (218) 878-0805
Other practice location 1
300 S Bruce St
Marshall, MN 56258-1934
Phone (507) 537-9172
Other names 1
- Karen Marie Kersting
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Avenue Therapies | Physical Therapist | Current | Accepting new patients |
Locations
1204 Cloquet Ave
Cloquet, MN 55720
Phone (218) 878-0805
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.
-
- Physical Therapist
- Cloquet, MN
- NPI 1437127834
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734480000000",
"number": "1053934877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1204 CLOQUET AVE",
"city": "CLOQUET",
"state": "MN",
"postal_code": "557201622",
"telephone_number": "218-878-0805",
"fax_number": "218-878-0794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1204 CLOQUET AVE",
"city": "CLOQUET",
"state": "MN",
"postal_code": "557201622",
"telephone_number": "218-878-0805",
"fax_number": "218-878-0794"
}
],
"practiceLocations": [
{
"address_1": "300 S Bruce St",
"address_purpose": "LOCATION",
"city": "Marshall",
"state": "MN",
"postal_code": "562581934",
"country_code": "US",
"telephone_number": "507-537-9172",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "KAREN",
"middle_name": "MARIE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-27",
"last_updated": "2024-12-18",
"certification_date": "2024-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KAREN",
"last_name": "KERSTING",
"middle_name": "MARIE",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Cloquet, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.