Wade Johnson, DO

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

63980 Issued in MN

Practice address

1025 Marsh St
Mankato, MN 56001-4752

Phone

(507) 625-4031

NPI assigned

Sep 14, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Sports Medicine

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mayo Clinic Health System-Southwest Minnesota RegionGroup PAC ID 4688585771, shared by 6 NPIs, 658 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Health System - Mankato Hospital, Mankato, MN, CCN 240093
• Mayo Clinic Health System New Prague Hospital, New Prague, MN, CCN 241361
• Mayo Clinic Health System - Fairmont Hospital, Fairmont, MN, CCN 240166
• River'S Edge Hospital & Clinic Hospital, St Peter, MN, CCN 241334

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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.

• Mayo Clinic Health System-Southwest Minnesota Region

  • Critical Access Hospital
  • New Prague, MN
  • NPI 1124035282
  Medicare reassignment NPD
• Mayo Clinic Health System-Southwest Minnesota Region

  • Multi-Specialty Clinic/Center
  • Mankato, MN
  • NPI 1578545422
  Medicare reassignment NPD
• Mayo Clinic Health System-Southwest Minnesota Region

  • Multi-Specialty Clinic/Center
  • Waseca, MN
  • NPI 1518494251
  NPD

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

• Mayo Clinic Health System-Fairmont

  • General Acute Care Hospital
  • Fairmont, MN
  • NPI 1821066499
  Care Compare affiliation
• Mayo Clinic Health System-Southwest Minnesota Region

  • Critical Access Hospital
  • New Prague, MN
  • NPI 1124035282
  Care Compare affiliation
• Mayo Clinic Health System-Southwest Minnesota Region

  • General Acute Care Hospital
  • Mankato, MN
  • NPI 1154302487
  Care Compare affiliation
• River'S Edge Hospital & Clinic

  • Critical Access Hospital
  • St Peter, MN
  • NPI 1407849367
  Care Compare affiliation

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

{
    "created_epoch": "1410652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1235530890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-625-4031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Woods Rd",
            "address_purpose": "LOCATION",
            "city": "Valhalla",
            "state": "NY",
            "postal_code": "10595",
            "country_code": "US",
            "telephone_number": "914-493-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Woods Rd",
            "address_purpose": "LOCATION",
            "city": "Valhalla",
            "state": "NY",
            "postal_code": "10595",
            "country_code": "US",
            "telephone_number": "914-493-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "WADE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-14",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "MN",
            "license": "63980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wjohnson358491@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1025 Marsh St",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560014752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madalyn Johnson, LICSW
• Paul L Johnson, M.D.
• Rachel Johnson
• Taylor Jo Johnson, LICSW
• Trisha Nicole Johnson, PHARMD
• Melinda Johnston
• Jessica Marie Jones, M.S., CCC-SLP
• Katelyn Jones, LADC
• Kathleen Teresa Jones, RPH
• Rachel Heather Jones, M.D.

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Mankato, MN
• Providers in Mankato, MN by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.