Individual provider Active NPI

Jennifer Susan Johnson, MA

  • Marriage & Family Therapist
  • Victoria, MN
National Provider Identifier
1477803435
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1772 Steiger Lake LN
#220
Victoria, MN 55386-7723
Phone
(952) 443-4600
NPI assigned
Sep 17, 2012
Last updated
Sep 17, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

1772 Steiger Lake LN
#220
Victoria, MN 55386-7723

Mailing address

7036 Highover CT S
Chanhassen, MN 55317-7569
Phone (612) 210-1748

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
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer S. Johnson Marriage and Family LLC Marriage & Family Therapist Past Accepting new patients
Lorenz Clinic, LLC Marriage & Family Therapist PastSince Jun 7, 2016 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16506/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1477803435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7036 HIGHOVER CT S",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553177569",
            "telephone_number": "612-210-1748",
            "fax_number": "952-470-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1772 STEIGER LAKE LN",
            "address_2": "#220",
            "city": "VICTORIA",
            "state": "MN",
            "postal_code": "553867723",
            "telephone_number": "952-443-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "SUSAN",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; 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.