Organization Active NPI

Johnson Healthcare Associates Inc

  • Family Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1407819022
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
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

Updated by the provider on Jun 10, 2008

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
0111978OtherMNMEDICA
1120003OtherMNMETROPOLITAN HEALTH PLAN
70296OtherMNHEALTHPARTNERS
01023902OtherMNPREFERRED ONE
145130800MedicaidMN
P477OtherMNUCARE
55N80JOOtherMNBLUES
038417100MedicaidMN
CB6880OtherMNRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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.

Verify at the official NPI Registry.