Benjamin Edward Michael Johnson, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

517-13 Issued in ND

Practice address

2751 2ND Ave N Stop 9013
Hyslop Sports Center Room 144
Grand Forks, ND 58202-9013

Phone

(701) 777-6572

NPI assigned

Mar 10, 2015

Last updated

Mar 10, 2015By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• University of North Dakota

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1952969099
  NPD (past)
• University of North Dakota Center for Sports Medicine

  • Physical Therapy Clinic/Center
  • Grand Forks, ND
  • NPI 1215080437
  NPD (past)

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1356734651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 2ND AVE N STOP 9013",
            "address_2": "HYSLOP SPORTS CENTER ROOM 144",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582029013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 2ND AVE N STOP 9013",
            "address_2": "HYSLOP SPORTS CENTER ROOM 144",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582029013",
            "telephone_number": "701-777-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BENJAMIN",
        "middle_name": "EDWARD MICHAEL",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-10",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ND",
            "license": "517-13",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa L Johnsen, OD
• Alyssa Johnson, PHARMD
• Alyssa D Johnson
• Andrew Johnson
• Arlene Johnson, DPT
• Beverly Jane Johnson, PT
• Blake Edward Johnson
• Braelyn Johnson
• Brittany R Johnson, PT
• Brittney Lorraine Johnson, PTA

• Athletic Trainer in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Athletic Trainer in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; 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.