Benjamin H Johnson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

39802 Issued in MN

Practice address

4190 Loberg Ave
Duluth, MN 55811-2652

Phone

(218) 249-5700

Fax

(218) 249-4666

NPI assigned

Jun 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485475200000",
    "number": "1164428280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 LOBERG AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558112652",
            "telephone_number": "218-249-5700",
            "fax_number": "218-249-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 LOBERG AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558112652",
            "telephone_number": "218-249-5700",
            "fax_number": "218-249-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BENJAMIN",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2017-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "30419",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "39802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31750700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Sue Johnson, DPT
• Amy Lee Johnson
• Amy Therese Johnson
• Anastasia Marie Johnson
• Ashley Anna Johnson
• Brooke Elizabeth Johnson, PA-C
• Bryan Douglas Johnson
• Cameron David Johnson, DO
• Carol Ann Johnson, LICSW
• Carol Katharine Miller Johnson, LMFT

• Family Medicine Physician in Duluth, MN
• Providers in Duluth, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; 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.