Individual provider Active NPI

Sherry A Johnson, C-FNP, CNS

  • Nurse Practitioner
  • Duluth, MN
National Provider Identifier
1154371789
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R108737-8 Issued in MN
Practice address
1001 E Superior St
Ste, L201
Duluth, MN 55802-2207
Phone
(218) 249-7990
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R108737-8 MN Primary

Addresses

Primary practice location

1001 E Superior St
Ste, L201
Duluth, MN 55802-2207

Mailing address

1001 E Superior St
Ste, L201
Duluth, MN 55802-2207
Phone (218) 249-7990

Other identifiers 1

IdentifierTypeStateIssuer
923108100MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040119000631 MN Practitioner - Nurse Practitioner 0840191102 Reassigns benefits to 1 organization
I20210422000776 WI Practitioner - Nurse Practitioner 0840191102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St. Luke'S Hospital of DuluthGroup PAC ID 7113834839, shared by 9 NPIs, 409 clinicians

Practice addresses (Care Compare)

1000 E 1St St
Duluth, MN 55805-2297

1011 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7000

1015 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7860

109 N 28TH St E
Superior, WI 54880-6548
Phone (715) 395-3900

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5439

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Duluth, MN, CCN 240047
  • Community Memorial Hospital Hospital, Cloquet, MN, CCN 241364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R108737-8MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Hospital of Duluth CurrentSince Sep 2, 2003 Accepting new patients
St. Luke'S Hospital of Duluth Current Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Jan 9, 2021 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Sep 2, 2003 Accepting new patients
St. Luke'S Hospital of Duluth Current Accepting new patients
St. Luke'S Hospital of Duluth Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1001 E Superior St
Ste L201
Duluth, MN 55802
Phone (218) 249-3057

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

26 E Superior St
Ste 205
Duluth, MN 55802
Phone (218) 249-4300

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

1001 E Superior St
Ste L401
Duluth, MN 55802
Phone (218) 249-7960

619 W Central Entrance
Duluth, MN 55811
Phone (218) 249-4987

109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900

3500 Tower Ave
Ste 1
Superior, WI 54880
Phone (715) 395-5457

Interoperability endpoints

  • Direct secure messaging: sjohnson237464@direct.aspirus.org

Organizations & group practices 6

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.

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1154371789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E SUPERIOR ST",
            "address_2": "STE, L201",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022207",
            "telephone_number": "218-249-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E SUPERIOR ST",
            "address_2": "STE, L201",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022207",
            "telephone_number": "218-249-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHERRY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "C-FNP, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R108737-8",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "923108100",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "1001 E Superior St",
            "address_2": "Ste, L201",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558022207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.