NPIMap

Individual provider Active NPI

Scott William Johnson

  • Obstetrics & Gynecology Physician
  • Duluth, MN
National Provider Identifier
1063445922
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
32881 Issued in MN
Practice address
400 E 3Rd St
Duluth, MN 55805-1951
Phone
(218) 786-8364
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 32881 MN Primary
Obstetrics & Gynecology Physician 207V00000X 14344 ND

Addresses

Primary practice location

400 E 3Rd St
Duluth, MN 55805-1951

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Other identifiers 2

IdentifierTypeStateIssuer
936395500MedicaidMN
31490800MedicaidWI

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
I20091116000403 MN Practitioner - Obstetrics/Gynecology 1557409323 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Mayo Medical School, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alomere HealthGroup PAC ID 9931690047, 123 clinicians

Practice addresses (Care Compare)

111 17TH Ave E
Alexandria, MN 56308-5273
Phone (320) 762-1511

111 W Vernon Ave
Fergus Falls, MN 56537-2741
Phone (218) 739-2221

649 /2 State St NW
Evansville, MN 56326-8124
Phone (218) 948-2040

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32881MNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
International Falls Memorial Hospital Association CurrentSince Jan 15, 2020 Accepting new patients
Alexandria Clinic PA Current Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Jul 30, 2018 Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Jul 30, 2018 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Apr 27, 2024 Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
International Falls Memorial Hospital Association CurrentSince Jan 15, 2020 Accepting new patients
West Central Pathology and Laboratory Medicine PA Current Accepting new patients
Lake Region Healthcare Corporation CurrentSince Dec 31, 2025 Accepting new patients
Douglas County Hospital Current Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Apr 27, 2024 Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Jun 17, 2022 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
Lake Region Healthcare Corporation CurrentSince Jun 17, 2022 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Dec 31, 2025 Accepting new patients
Essentia Health Virginia, LLC Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

111 17th Ave E
Alexandria, MN 56308
Phone (320) 762-1511

610 30th Ave W
Alexandria, MN 56308
Phone (320) 763-2540

600 Main Ave S
Birchdale, MN 56623
Phone (218) 634-1655

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

1001 E Superior St
Ste 301
Duluth, MN 55802
Phone (218) 249-4700

712 S Cascade St
Fergus Falls, MN 56537

111 SE 3rd St
Grand Rapids, MN 55744
Phone (218) 326-3401

1601 Golf Course Rd
Grand Rapids, MN 55744
Phone (218) 326-3401

1400 Highway 71
Intl Falls, MN 56649
Phone (218) 283-4481

901 9th St N
Virginia, MN 55792
Phone (218) 741-3340

Interoperability endpoints

  • Direct secure messaging: sjohnson599192@direct.centracare.com
  • Direct secure messaging: sjohnson367134@direct.aspirus.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/

Organizations & group practices 18

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

View all 18

Hospital & facility affiliations 4

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1063445922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SCOTT",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "32881",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ND",
            "license": "14344",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "936395500",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31490800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.