Individual provider Active NPI

Amanda Kay Johnson, CSA

  • Surgical Physician Assistant
  • Rochester, MN
National Provider Identifier
1417288945
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
201 W Center St Ei-01 Surgical Assistant
Rochester, MN 55902-3003
Phone
(507) 266-2827
Fax
(507) 266-1978
NPI assigned
Jan 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

201 W Center St Ei-01 Surgical Assistant
Rochester, MN 55902-3003

Mailing address

114 W. Main St.
PO Box 54
Dodge Center, MN 55927
Phone (507) 374-2335

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

NPI Registry JSON

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1417288945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 W. MAIN ST.",
            "address_2": "PO BOX 54",
            "city": "DODGE CENTER",
            "state": "MN",
            "postal_code": "55927",
            "telephone_number": "507-374-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W CENTER ST EI-01 SURGICAL ASSISTANT",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559023003",
            "telephone_number": "507-266-2827",
            "fax_number": "507-266-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMANDA",
        "middle_name": "KAY",
        "name_prefix": "Miss",
        "credential": "CSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-22",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jan 22, 2010; 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.