NPIMap

Organization Active NPI

Johnson Spinal Care Associates, P.a.

  • Chiropractor
  • Apple Valley, MN
National Provider Identifier
1285711663
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4526179 Issued in MN
Legal business name
JOHNSON SPINAL CARE ASSOCIATES, P.A.
Practice address
14859 Energy Way
Apple Valley, MN 55124-5763
Phone
(952) 432-3333
Fax
(952) 432-4444
NPI assigned
Nov 1, 2006
Last updated
Mar 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Authorized official

Name
Dr. Kerry Lee Johnson, D.C.
Title
Owner/Doctor
Phone
(952) 432-3333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4526179 MN Primary

Addresses

Primary practice location

14859 Energy Way
Apple Valley, MN 55124-5763

Mailing address

14859 Energy Way
Apple Valley, MN 55124-5763
Phone (952) 432-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040417000203 MN Part B Supplier - Clinic/Group Practice 4587659719 Receives reassigned benefits from 6 practitioners
Practice locations: Apple Valley, MN; Savage, MN; Vadnais Heights, MN

National Provider Directory

National Provider Directory

Locations

14465 S Robert Trl
Rosemount, MN 55068
Phone (651) 423-5250

14859 Energy Way
Saint Paul, MN 55124
Phone (651) 423-5250

8678 Eagle Creek Cir
Savage, MN 55378
Phone (952) 432-3333

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1285711663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14859 ENERGY WAY",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551245763",
            "telephone_number": "952-432-3333",
            "fax_number": "952-432-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14859 ENERGY WAY",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551245763",
            "telephone_number": "952-432-3333",
            "fax_number": "952-432-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON SPINAL CARE ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "952-432-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4526179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.