Jewel Johnson

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

12799 Issued in MN

Practice address

11555 Boulder CT
Maple Grove, MN 55311-7521

Phone

(612) 351-7100

NPI assigned

Sep 8, 2025

Sex

Female

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

Practice roles

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.

• Manasseh Home Healthcare LLC

  • Home Health Agency
  • Maple Grove, MN
  • NPI 1184425944
  NPD Authorized official

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1336020353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11555 BOULDER CT",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553117521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11555 BOULDER CT",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553117521",
            "telephone_number": "612-351-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEWEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "12799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geniyah Johnson
• Grace Johnson, LICSW
• Janell Ruth Johnson
• Jean Johnson
• Jennifer Marie Johnson, LPCC
• Karen Marie Johnson, PT
• Keith Johnson, MD
• Keith Michael Johnson, DC
• Kyrsten Ann Johnson, M.D.
• Madison Anne Johnson

• Nurse Practitioner in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.