Individual provider Active NPI

Katy-Cecilie Johannessen, DC

  • Chiropractor
  • Minneapolis, MN
National Provider Identifier
1538820535
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6932 Issued in MN
Practice address
5536 Chicago Ave
Minneapolis, MN 55417-2446
Phone
(612) 827-0657
Fax
(651) 762-8070
NPI assigned
Jan 3, 2022
Last updated
Jan 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6932 MN Primary

Addresses

Primary practice location

5536 Chicago Ave
Minneapolis, MN 55417-2446

Mailing address

5536 Chicago Ave
Minneapolis, MN 55417-2446
Phone (612) 827-0657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220408001362 MN Practitioner - Chiropractic 4981090438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southside Chiropractic, PAGroup PAC ID 3577512961, 2 clinicians

Practice addresses (Care Compare)

5536 Chicago Ave
Minneapolis, MN 55417-2446
Phone (612) 827-0657

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Chiropractic, P.a. Chiropractor CurrentSince Mar 17, 2024 Accepting new patients
In8 Family Chiropractic PA Chiropractor PastSince Mar 17, 2024 Accepting new patients

Locations

5536 Chicago Ave
Minneapolis, MN 55417
Phone (612) 827-0657

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": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1538820535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5536 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172446",
            "telephone_number": "612-827-0657",
            "fax_number": "612-827-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5536 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172446",
            "telephone_number": "612-827-0657",
            "fax_number": "651-762-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANNESSEN",
        "first_name": "KATY-CECILIE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-03",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6932",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.