Active NPI
Johnson Healthcare Associates Inc
- Family Medicine Physician
- Minneapolis, MN
National Provider Identifier
1407819022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- JOHNSON HEALTHCARE ASSOCIATES INC
- Practice address
- 2904 Johnson St NE
Minneapolis, MN 55418-2234 - Phone
- (612) 782-0900
- Fax
- (612) 788-4930
- NPI assigned
- Apr 7, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Art Fretag
- Title
- Business Manager
- Phone
- (612) 782-0900
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
2904 Johnson St NE
Minneapolis, MN 55418-2234
Mailing address
2904 Johnson St NE
Minneapolis, MN 55418-2234
Phone (612) 782-0900
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0111978 | Other | MN | MEDICA |
| 1120003 | Other | MN | METROPOLITAN HEALTH PLAN |
| 70296 | Other | MN | HEALTHPARTNERS |
| 01023902 | Other | MN | PREFERRED ONE |
| 145130800 | Medicaid | MN | |
| P477 | Other | MN | UCARE |
| 55N80JO | Other | MN | BLUES |
| 038417100 | Medicaid | MN | |
| CB6880 | Other | MN | RAILROAD MEDICARE |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Minneapolis, MN
- NPI 1639220866
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144368000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1213056000000",
"number": "1407819022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2904 JOHNSON ST NE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554182234",
"telephone_number": "612-782-0900",
"fax_number": "612-788-4930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2904 JOHNSON ST NE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554182234",
"telephone_number": "612-782-0900",
"fax_number": "612-788-4930"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOHNSON HEALTHCARE ASSOCIATES INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-07",
"last_updated": "2008-06-10",
"status": "A",
"authorized_official_last_name": "FRETAG",
"authorized_official_first_name": "ART",
"authorized_official_title_or_position": "BUSINESS MANAGER",
"authorized_official_telephone_number": "612-782-0900"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "0111978",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "METROPOLITAN HEALTH PLAN",
"identifier": "1120003",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "70296",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "01023902",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "145130800",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "P477",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUES",
"identifier": "55N80JO",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "038417100",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CB6880",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.