Individual provider Active NPI

Adam R Johnson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Minneapolis, MN
National Provider Identifier
1346402518
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
846 Issued in MN
Practice address
1 Veterans Dr
Minneapolis, MN 55417-2309
Phone
(612) 467-1001
Fax
(612) 467-2231
NPI assigned
Jun 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 846 MN Primary

Addresses

Primary practice location

1 Veterans Dr
Minneapolis, MN 55417-2309

Mailing address

1 Veterans Dr BLDG 70
2D Podiatry Clinic
Minneapolis, MN 55417-2309
Phone (612) 467-1013

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110610000526 MN Practitioner - Podiatry 3375720717 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Oct 1, 2014 Accepting new patients
Sanford Medical Center Fargo CurrentSince Oct 1, 2014 Accepting new patients

Locations

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

1300 Anne St NW
Bemidji, MN 56601
Phone (218) 333-5794

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1346402518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 VETERANS DR BLDG 70",
            "address_2": "2D PODIATRY CLINIC",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172309",
            "telephone_number": "612-467-1013",
            "fax_number": "612-467-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VETERANS DR",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172309",
            "telephone_number": "612-467-1001",
            "fax_number": "612-467-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ADAM",
        "middle_name": "R",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MN",
            "license": "846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.