Individual provider Active NPI

Julie M Johnson, MD

  • Family Medicine Physician
  • Saint Cloud, MN
National Provider Identifier
1235105388
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
45006 Issued in MN
Practice address
1511 Northway Dr
Ste 103
Saint Cloud, MN 56303-1262
Phone
(320) 227-5000
Fax
(320) 227-5025
NPI assigned
Feb 28, 2006
Last updated
Jan 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 45006 MN Primary
Internal Medicine Physician 207R00000X 45006 MN

Addresses

Primary practice location

1511 Northway Dr
Ste 103
Saint Cloud, MN 56303-1262

Mailing address

1511 Northway Dr
Ste 103
Saint Cloud, MN 56303-1262
Phone (320) 253-5220

Other practice location 1

2251 Connecticut Ave S
Sartell, MN 56377-2486
Phone (320) 253-5220

Other identifiers 1

IdentifierTypeStateIssuer
040993600MedicaidMN

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100428000589 MN Practitioner - Family Practice 3779664743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Dakota School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Simplicity Health PAGroup PAC ID 1557617354, 16 clinicians

Practice addresses (Care Compare)

3290 42ND Ave S
Saint Cloud, MN 56301-6251
Phone (320) 227-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45006MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Simplicity Health PA Family Medicine CurrentSince Jan 1, 2020 Accepting new patients

Locations

7801 E Bush Lake Rd
Ste 320
Minneapolis, MN 55439
Phone (952) 831-5773

1511 Northway Dr
Ste 103
Saint Cloud, MN 56303
Phone (320) 227-5000

3290 42nd Ave S
Saint Cloud, MN 56301
Phone (320) 227-5000

Interoperability endpoints

  • Direct secure messaging: jjohnson1354@direct.centracare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1235105388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 NORTHWAY DR",
            "address_2": "STE 103",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031262",
            "telephone_number": "320-253-5220",
            "fax_number": "320-203-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 NORTHWAY DR",
            "address_2": "STE 103",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031262",
            "telephone_number": "320-227-5000",
            "fax_number": "320-227-5025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2251 Connecticut Ave S",
            "address_purpose": "LOCATION",
            "city": "Sartell",
            "state": "MN",
            "postal_code": "563772486",
            "country_code": "US",
            "telephone_number": "320-253-5220",
            "fax_number": "320-203-2113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JULIE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "45006",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "45006",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040993600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.