Active NPI
Jeremy Loren Johnson, PHARM.D.
- Pharmacist
- Austin, MN
National Provider Identifier
1225031685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 117762-8
- Practice address
- 1707 2ND St SW
Austin, MN 55912-1985 - Phone
- (507) 434-0842
- NPI assigned
- May 31, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 117762-8 | MN | Primary |
Addresses
Primary practice location
1707 2ND St SW
Austin, MN 55912-1985
Mailing address
800 27TH St SW
Austin, MN 55912-5400
Phone (507) 434-0842
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117762-8 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585440000000",
"number": "1225031685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 27TH ST SW",
"city": "AUSTIN",
"state": "MN",
"postal_code": "559125400",
"telephone_number": "507-434-0842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1707 2ND ST SW",
"city": "AUSTIN",
"state": "MN",
"postal_code": "559121985",
"telephone_number": "507-434-0842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JEREMY",
"middle_name": "LOREN",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-05-31",
"last_updated": "2020-03-29",
"certification_date": "2020-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "117762-8",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.