Craig Steven Johnson, D.C.
Individual provider Active NPI Chiropractor · Annandale, MN
NPI 1265747455 · NPPES record last updated Jun 10, 2011
Key facts
- NPI
- 1265747455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 5421 (MN)
- Practice address
- 93 Oak Ave S
Suite 2
Annandale, MN 55302-1205 - Phone
- (612) 298-0792
- NPI assigned
- Aug 11, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
93 Oak Ave S
Suite 2
Annandale, MN 55302-1205
Phone (320) 274-3499
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110308001059 | MN | Practitioner - Chiropractic | 1355523507 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5421 | MN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Twin Lakes Chiropractic LLC | Chiropractor | Current |
Accepting new patients |
| McConkey Chiropractic Clinic PA | Chiropractor | Current |
Accepting new patients |
| Millsop Chiropractic, P.a. | Chiropractor | Past |
Accepting new patients |
| Preferred Chiropractic Associates Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5421 | MN | Yes |
Addresses
Primary practice location
93 Oak Ave S
Suite 2
Annandale, MN 55302-1205
Mailing address
PO Box 95
Annandale, MN 55302-0095
Phone (612) 298-0792
Other providers in Annandale, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.