Active NPI
Robyn Marie Johnson, PSYD, LP
- Psychologist
- Eden Prairie, MN
National Provider Identifier
1063510444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4393
- Practice address
- 12100 Singletree LN
Suite 142
Eden Prairie, MN 55344-7919 - Phone
- (612) 747-6139
- Fax
- (952) 746-1201
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4393 | MN | Primary |
Addresses
Primary practice location
12100 Singletree LN
Suite 142
Eden Prairie, MN 55344-7919
Mailing address
12100 Singletree LN
Suite 142
Eden Prairie, MN 55344-7919
Phone (612) 747-6139
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4393 | MN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240790400000",
"number": "1063510444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12100 SINGLETREE LN",
"address_2": "SUITE 142",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553447919",
"telephone_number": "612-747-6139",
"fax_number": "952-746-1201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12100 SINGLETREE LN",
"address_2": "SUITE 142",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553447919",
"telephone_number": "612-747-6139",
"fax_number": "952-746-1201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ROBYN",
"middle_name": "MARIE",
"credential": "PSYD, LP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2009-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "4393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eden Prairie, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.