Kelsey Nicole Johnson, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11143 Issued in MN

Practice address

3555 Willow Lake Blvd Ste 290
Vadnais Heights, MN 55110-4465

Phone

(952) 431-5330

NPI assigned

Dec 28, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelsey Nicole Rudsinski Former name

Medicare fee-for-service enrollment

Enrolled in MN

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 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Danielle Golden, Crna, PAGroup PAC ID 6305934597, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Danielle Golden, Crna, PA

  dba The Remedy

  • Adult Mental Health Clinic/Center
  • Vadnais Heights, MN
  • NPI 1598954687
  Medicare reassignment Care Compare group NPD
• Advanced Brain and Body Clinic PLLC

  • Specialist
  • Golden Valley, MN
  • NPI 1447816632
  Medicare reassignment NPD

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

{
    "created_epoch": "1703721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1184493355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 WILLOW LAKE BLVD STE 290",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551104465",
            "telephone_number": "952-431-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 WILLOW LAKE BLVD STE 290",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551104465",
            "telephone_number": "952-431-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KELSEY",
        "middle_name": "NICOLE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-28",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "11143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "RUDSINSKI",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Marie Johanson
• Stacey John, ATC, OTC
• Alecia Ann Johnson, PT
• Alyssa N Johnson, DPT
• Greg Michael Johnson, M.D
• Joanne Kaseman, PA-C
• Emily Hope Kelley
• Marjan Sarah Khazaeli, PHARM.D., BCACP
• David A Kittleson, MD
• Zgia Melissa Kjonaas, D.C.

• Psychiatric/Mental Health Nurse Practitioner in Vadnais Heights, MN
• Providers in Vadnais Heights, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.