Carly Kristin Martha Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

14497 Issued in MN

Practice address

7373 France Ave S Ste 208
Edina, MN 55435-4598

Phone

(952) 835-1311

Fax

(952) 428-0095

NPI assigned

Feb 3, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• St. Francis Regional Medical Center

  • Urgent Care Clinic/Center
  • Shakopee, MN
  • NPI 1447605514
  Medicare reassignment NPD
• Allina Health System

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment
• MN UC Providers LTD

  • Urgent Care Clinic/Center
  • Hopkins, MN
  • NPI 1871265074
  Medicare reassignment
• Allina Health System

  • Family Medicine Physician
  • Woodbury, MN
  • NPI 1902102353
  NPD
• Allina Health System

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD
• MN UC Providers LTD

  • Urgent Care Clinic/Center
  • Maple Grove, MN
  • NPI 1891479945
  NPD

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1376135129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 FRANCE AVE S STE 208",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354598",
            "telephone_number": "952-835-1311",
            "fax_number": "952-428-0095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Wesley Dr",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381166426",
            "country_code": "US",
            "telephone_number": "901-516-3700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CARLY",
        "middle_name": "KRISTIN MARTHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-03",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Lynn Johnson, PSY.D.
• Angela Susan Johnson, NP-C
• Beverly Jean Johnson, MA.LP
• Bradford V Johnson, MD
• Brent Lee Johnson
• Christopher Adam Johnson, A.T.C.
• Craig R Johnson, LADC
• David B Johnson, D.C.
• Erin Johnson
• Gary B Johnson, M.D., MPH, FACOEM

• Physician Assistant in Edina, MN
• Providers in Edina, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.