Individual provider Active NPI

Terrance L Johnson, M.D.

  • Orthopaedic Surgery Physician
  • Bemidji, MN
National Provider Identifier
1194721290
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
22385 Issued in MN
Practice address
3807 Greenleaf Ave NW
Bemidji, MN 56601-5817
Phone
(218) 751-9746
Fax
(218) 333-4776
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 22385 MN
Orthopaedic Surgery Physician 207X00000X 22385 MN Primary

Addresses

Primary practice location

3807 Greenleaf Ave NW
Bemidji, MN 56601-5817

Mailing address

3807 Greenleaf Ave NW
Bemidji, MN 56601-5817
Phone (218) 751-9746

Other identifiers 1

IdentifierTypeStateIssuer
437562900MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tjohnson1841444@direct.sanfordhealth.org

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
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1194721290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3807 GREENLEAF AVE NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015817",
            "telephone_number": "218-751-9746",
            "fax_number": "218-333-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3807 GREENLEAF AVE NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015817",
            "telephone_number": "218-751-9746",
            "fax_number": "218-333-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TERRANCE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "22385",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "22385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "437562900",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tjohnson1841444@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "1300 Anne St NW",
            "city": "Bemidji",
            "state": "MN",
            "country_code": "US",
            "postal_code": "566015103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.