Mark Robert Johnson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2010 Issued in MN

Practice address

2780 Snelling Ave N
Suite 301
Roseville, MN 55113-7115

Phone

(651) 633-9667

Fax

(651) 633-4203

NPI assigned

Jan 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225189533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 4TH AVE NE",
            "city": "OSSEO",
            "state": "MN",
            "postal_code": "553691122",
            "telephone_number": "763-425-2347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 SNELLING AVE N",
            "address_2": "SUITE 301",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551137115",
            "telephone_number": "651-633-9667",
            "fax_number": "651-633-4203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARK",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua B Johnson, MD
• Julie Kay Johnson, PHARM.D.
• Keith W. Johnson, M.D.
• Kenton M Johnson, DDS MS
• Lisa J Johnson
• Pamela Johnson, MA, LMFT, LP
• Summer Johnson
• Sean K Johnston, M.D.
• Joining Hands Child and Family Counseling Services, LLC
• Caroline Jolstad

• Chiropractor in Roseville, MN
• Providers in Roseville, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.