Individual provider Active NPI

Paul David Johnson, PHARM D, RPH

  • Pharmacist
  • Rochester, MN
National Provider Identifier
1366825390
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
122328 Issued in MN
Practice address
1216 2ND St SW
Suite M600B
Rochester, MN 55902-1906
Phone
(507) 255-5731
NPI assigned
Jul 8, 2015
Last updated
Mar 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 122328 MN Primary

Addresses

Primary practice location

1216 2ND St SW
Suite M600B
Rochester, MN 55902-1906

Mailing address

1216 2ND St SW
Suite M600B
Rochester, MN 55902-1906
Phone (507) 255-5731

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pjohnson129865@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
122328MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Foundation for Medical Education & Research Past Accepting new patients
Mayo Foundation for Medical Education & Research Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pjohnson129865@ehrdirect.mayoclinicmsg.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1366825390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 2ND ST SW",
            "address_2": "SUITE M600B",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559021906",
            "telephone_number": "507-255-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 2ND ST SW",
            "address_2": "SUITE M600B",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559021906",
            "telephone_number": "507-255-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAUL",
        "middle_name": "DAVID",
        "credential": "PHARM D, RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-08",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "122328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pjohnson129865@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1216 2nd St SW",
            "address_2": "Suite M600B",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559021906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.