Johan Septimus Bakken, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

31523 Issued in MN

Practice address

1001 E Superior St
Suite L201
Duluth, MN 55802-2207

Phone

(218) 249-3057

NPI assigned

May 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1366491789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E SUPERIOR ST",
            "address_2": "SUITE L201",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022207",
            "telephone_number": "218-249-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E SUPERIOR ST",
            "address_2": "SUITE L201",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022207",
            "telephone_number": "218-249-3057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKKEN",
        "first_name": "JOHAN",
        "middle_name": "SEPTIMUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MN",
            "license": "31523",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "31523",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "661088900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawn Celeste Baker, CRNA
• Steven Egan Baker, MD
• Jerry Charles Bakka, PH.D.
• Deanna Rae Bakken
• Johan Christian Bakken, MD
• George Michael Balach I, D.D.S.
• Jordann Makail Balaich, RN
• David T Baldes, MD
• Megan Browning Baldes, M.D.
• Gail Elaine Baldwin, MD

• Infectious Disease Physician in Duluth, MN
• Providers in Duluth, MN by specialty
• Infectious Disease Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.