Travis Marshall Johnson, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

1175 Issued in MN

Practice address

49725 County 83
Staples, MN 56479-5280

Phone

(218) 894-1515

Fax

(218) 894-8767

NPI assigned

Apr 1, 2016

Last updated

Apr 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, MN2 enrollments

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 2

Specialty

Podiatry

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakewood Health SystemGroup PAC ID 1052229671, shared by 15 NPIs, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakewood Health System Hospital, Staples, MN, CCN 241329

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tjohnson706350@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lakewood Health System

  • Critical Access Hospital
  • Staples, MN
  • NPI 1295726362
  Medicare reassignment NPD
• Lakewood Health System

  dba Lakewood Clinic Staples

  • Rural Health Clinic/Center
  • Staples, MN
  • NPI 1841280823
  Medicare reassignment NPD
• Tenet Florida Physician Services II, LLC

  • Orthopaedic Surgery Physician
  • West Palm Beach, FL
  • NPI 1912266420

  Foot & Ankle Surgery

  Medicare reassignment NPD
• Timothy P Mason DPM PA

  dba Foot and Ankle Specialists of Orlando

  • Foot & Ankle Surgery Podiatrist
  • Oviedo, FL
  • NPI 1205079571
  Medicare reassignment NPD
• Lakewood Health System

  dba Longbella Drug by Lakewood Health System - Pillager Clinic

  • Community/Retail Pharmacy
  • Pillager, MN
  • NPI 1396519906
  NPD
• Tenet Florida Physician Services II, LLC

  dba Cantor Spine Center-At The Paley Orthopedic & Spine Institute

  • Durable Medical Equipment & Medical Supplies
  • Boca Raton, FL
  • NPI 1770391286
  NPD
• Lakewood Health System

  dba Lakewood Clinic Eagle Bend

  • Rural Health Clinic/Center
  • Eagle Bend, MN
  • NPI 1093706160
  NPD (past)

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

• Lakewood Health System

  • Critical Access Hospital
  • Staples, MN
  • NPI 1295726362
  Care Compare affiliation

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

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1346603859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49725 COUNTY 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795280",
            "telephone_number": "218-894-1515",
            "fax_number": "218-894-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49725 COUNTY 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795280",
            "telephone_number": "218-894-1515",
            "fax_number": "218-894-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TRAVIS",
        "middle_name": "MARSHALL",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-01",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MN",
            "license": "1175",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO4046",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Independent School District 2170
• Infinite Health Collaborative, PA (Twin Cities Orthopedics)
• Sarah Jane Israelson, M.D.
• Jan Johnson (First Step)
• Jody Lynn Jenson, MSN,APRN,PMHNP
• Barbara Kaneski I, CNP
• Brita Rose Karolus, PT
• Olivia Kastello, MD
• Tyler Kline, PT
• Joshua John Klous, NP

• Foot & Ankle Surgery Podiatrist in Staples, MN
• Providers in Staples, MN by specialty
• Foot & Ankle Surgery Podiatrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.