Individual provider Active NPI

Jonas Johnson, DC

  • Chiropractor
  • Monticello, MN
National Provider Identifier
1154476786
Registry record updated Oct 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4879 Issued in MN
Practice address
211 Highway 25 S
Monticello, MN 55362-9306
Phone
(763) 295-4105
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4879 MN Primary

Addresses

Primary practice location

211 Highway 25 S
Monticello, MN 55362-9306

Mailing address

211 Highway 25 S
PO Box 717
Monticello, MN 55362-9306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070214000110 MN Practitioner - Chiropractic 0143222521 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4879MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Belde Chiropractic Clinic, PA Chiropractor CurrentSince Dec 1, 2006 Accepting new patients
IHS Midwest PC Chiropractor PastSince Mar 1, 2011 Accepting new patients

Locations

211 Highway 25 S
Monticello, MN 55362
Phone (651) 334-1290

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351209600000",
    "number": "1154476786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 HIGHWAY 25 S",
            "address_2": "PO BOX 717",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553629306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 HIGHWAY 25 S",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553629306",
            "telephone_number": "763-295-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JONAS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2012-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.