Individual provider Active NPI

Erika Johnson, FNP-BC

  • Family Nurse Practitioner
  • Shakopee, MN
National Provider Identifier
1467998617
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP4964 Issued in MN
Practice address
8170 Old Carriage CT Ste 100
Shakopee, MN 55379-3164
Phone
(952) 428-3600
Fax
(952) 428-3636
NPI assigned
Jan 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP4964 MN Primary

Addresses

Primary practice location

8170 Old Carriage CT Ste 100
Shakopee, MN 55379-3164

Mailing address

8170 Old Carriage CT Ste 100
Shakopee, MN 55379-3164
Phone (952) 428-3600

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170315000296 MN Practitioner - Nurse Practitioner 9133404106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8170 Old Carriage CT
Suite 100
Shakopee, MN 55379-3164
Phone (952) 428-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP4964MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Regional Medical Center CurrentSince Oct 1, 2019 Accepting new patients

Locations

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

6150 Egan Dr
Savage, MN 55378
Phone (952) 228-2552

8170 Old Carriage Ct
Ste 100
Shakopee, MN 55379
Phone (952) 428-3600

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1467998617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 OLD CARRIAGE CT STE 100",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553793164",
            "telephone_number": "952-428-3600",
            "fax_number": "952-428-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8170 OLD CARRIAGE CT STE 100",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553793164",
            "telephone_number": "952-428-3600",
            "fax_number": "952-428-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ERIKA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-12",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP4964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

Verify at the official NPI Registry.