Individual provider Active NPI

Anna Elizabeth Johansen, FNP

  • Primary Care Nurse Practitioner
  • Olivia, MN
National Provider Identifier
1558073361
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
9836 Issued in MN
Practice address
100 Healthy Way
Olivia, MN 56277-1117
Phone
(900) 916-1836
NPI assigned
Dec 23, 2022
Last updated
Dec 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 9836 MN Primary

Addresses

Primary practice location

100 Healthy Way
Olivia, MN 56277-1117

Mailing address

1597 290TH Ave
Garvin, MN 56132-1240
Phone (507) 829-9295

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL rchospital.com

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
I20230411001707 MN Practitioner - Nurse Practitioner 0840665527 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Health Care IncGroup PAC ID 3476447541, 156 clinicians

Practice addresses (Care Compare)

1216 Ryans Rd
Suite 3
Worthington, MN 56187-1781
Phone (507) 372-6522

1521 Carlson St
Suite 100
Marshall, MN 56258-2626
Phone (507) 473-4800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9836MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Health Care, Inc Current Accepting new patients
Healthpartners RC CurrentSince Jan 18, 2023 Accepting new patients
Healthpartners RC CurrentSince Jan 18, 2023 Accepting new patients
Rural Health Care, Inc CurrentSince Mar 9, 2024 Accepting new patients
Rural Health Care, Inc. Past Accepting new patients

Locations

1521 Carlson St
Ste 100
Marshall, MN 56258
Phone (507) 476-4800

300 S Bruce St
Ste 100
Marshall, MN 56258

100 Healthy Way
Olivia, MN 56277
Phone (320) 523-1261

1216 Ryans Rd
Worthington, MN 56187
Phone (507) 372-2921

1216 Ryans Rd
Ste 3
Worthington, MN 56187
Phone (507) 372-6522

Interoperability endpoints

  • Direct secure messaging: anna.johansen@avera.sdhealthlink.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1671753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1558073361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1597 290TH AVE",
            "city": "GARVIN",
            "state": "MN",
            "postal_code": "561321240",
            "telephone_number": "507-829-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HEALTHY WAY",
            "city": "OLIVIA",
            "state": "MN",
            "postal_code": "562771117",
            "telephone_number": "900-916-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSEN",
        "first_name": "ANNA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-23",
        "last_updated": "2022-12-23",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MN",
            "license": "9836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "rchospital.com",
            "affiliation": "N",
            "address_1": "100 Healthy Way",
            "city": "Olivia",
            "state": "MN",
            "country_code": "US",
            "postal_code": "562771117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olivia, MN

Sources for this page

Verify at the official NPI Registry.