Individual provider Active NPI

Christian Allen Johnson, DC

  • Chiropractor
  • Wayzata, MN
National Provider Identifier
1144844598
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6706 Issued in MN
Practice address
18202 Minnetonka Blvd Ste 101a
Wayzata, MN 55391-4136
Phone
(952) 956-6444
Fax
(952) 808-3112
NPI assigned
Jun 2, 2020
Last updated
Sep 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6706 MN Primary

Addresses

Primary practice location

18202 Minnetonka Blvd Ste 101a
Wayzata, MN 55391-4136

Mailing address

5697 Green Circle Dr Apt 309
Minnetonka, MN 55343-9649

Other practice location 1

4401 Egan Dr
Savage, MN 55378-2024
Phone (952) 746-4162

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Finish Line Wellness PastSince May 27, 2020 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1144844598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5697 GREEN CIRCLE DR APT 309",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18202 MINNETONKA BLVD STE 101A",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553914136",
            "telephone_number": "952-956-6444",
            "fax_number": "952-808-3112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4401 Egan Dr",
            "address_purpose": "LOCATION",
            "city": "Savage",
            "state": "MN",
            "postal_code": "553782024",
            "country_code": "US",
            "telephone_number": "952-746-4162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHRISTIAN",
        "middle_name": "ALLEN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-02",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayzata, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.