Jeffrey Todd Johnson, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1088 Issued in MN

Practice address

720 4TH Ave S
214 Halenbeck Hall
Saint Cloud, MN 56301-4442

Phone

(320) 308-2503

NPI assigned

Jan 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437202884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 RIVERSIDE DR NE",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563040345",
            "telephone_number": "320-656-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 4TH AVE S",
            "address_2": "214 HALENBECK HALL",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014442",
            "telephone_number": "320-308-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEFFREY",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "1088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Johnson
• Icephine Ballard Johnson, NURSE PRACTITIONER
• Jacqueline Ann Johnson, WHNP
• Janelle L Johnson, MD
• Jeanette Johnson
• John C Johnson, MD
• Josie Johnson, CP/BOCO
• Julie M Johnson, MD
• Kalie Johnson, PA
• Kalin Ann Marie Johnson

• Athletic Trainer in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Athletic Trainer in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.