NPIMap

Individual provider Active NPI

Chris J Johnson, M.D.

  • Family Medicine Physician
  • Minnetrista, MN
National Provider Identifier
1104800267
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26258 Issued in MN
Practice address
5520 Ridgewood CV
Minnetrista, MN 55364-8239
Phone
(612) 868-0136
Fax
(952) 472-7918
NPI assigned
Dec 2, 2005
Last updated
Oct 25, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26258 MN Primary

Addresses

Primary practice location

5520 Ridgewood CV
Minnetrista, MN 55364-8239

Mailing address

5520 Ridgewood CV
Minnetrista, MN 55364-8239
Phone (612) 868-0136

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
I20090401000416 MN Practitioner - Family Practice 1759448046 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Northwestern University Feinberg Medical School, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Consultative Health and Medicine PAGroup PAC ID 6305024373, 14 clinicians

Practice addresses (Care Compare)

5520 Ridgewood CV
Minnetrista, MN 55364-8239
Phone 80087305611

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26258MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Family Medicine CurrentSince Jan 1, 2008 Accepting new patients
Consultative Health and Medicine, PA Family Medicine CurrentSince May 1, 2011 Accepting new patients
Park Nicollet Clinic Family Medicine CurrentSince Jan 1, 2008 Accepting new patients
Auburn Manor PastSince Nov 1, 2020 Accepting new patients
Crest View Corporation Past Accepting new patients
Crest View Corporation PastSince Feb 6, 2025 Accepting new patients
Auburn Manor Past Accepting new patients
Chirocenter Inc. PastSince May 1, 2017 Accepting new patients

Locations

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Auburn Homes and ServicesChaska, MN, CCN 245604 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Nov 1, 2020
Nov 1, 2020
Crest View Lutheran HomeColumbia Heights, MN, CCN 245018 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 1, 2022
Feb 6, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Auburn Manor
    • Skilled Nursing Facility
    • Chaska, MN
    • NPI 1184609448

    Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Crest View Corporation

    dba CV Lutheran Home, Blvd Apts, Royce Place, CV Home Care

    • Skilled Nursing Facility
    • Columbia Heights, MN
    • NPI 1336232057

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Organizations & group practices 8

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.

Hospital & facility affiliations 11

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1104800267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 RIDGEWOOD CV",
            "city": "MINNETRISTA",
            "state": "MN",
            "postal_code": "553648239",
            "telephone_number": "612-868-0136",
            "fax_number": "952-472-7918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 RIDGEWOOD CV",
            "city": "MINNETRISTA",
            "state": "MN",
            "postal_code": "553648239",
            "telephone_number": "612-868-0136",
            "fax_number": "952-472-7918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHRIS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "26258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetrista, MN

Sources for this page

Verify at the official NPI Registry.