Samuel Johnson

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2266 Issued in MN

Practice address

1500 Curve Crest Blvd W
Stillwater, MN 55082-6040

Phone

(651) 439-1234

NPI assigned

May 20, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Amery Regional Medical Center IncGroup PAC ID 2769391960, 124 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amery Hospital & Clinic Hospital, Amery, WI, CCN 521308
• Lakeview Memorial Hospital Hospital, Stillwater, MN, CCN 240066

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Amery Regional Medical Center, Inc.

  • Critical Access Hospital
  • Amery, WI
  • NPI 1093763518
  Medicare reassignment Care Compare group NPD
• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683

  WI

  Medicare reassignment Care Compare group NPD (past)
• Westfields Hospital, Inc.

  • Critical Access Hospital
  • New Richmond, WI
  • NPI 1881640183
  Medicare reassignment NPD
• Group Health, Inc.

  • Family Medicine Physician
  • Stillwater, MN
  • NPI 1245608454
  NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD
• Amery Regional Medical Center, Inc.

  • Rural Health Clinic/Center
  • Luck, WI
  • NPI 1851345268

  Physician Assistant

  NPD
• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Hudson, WI
  • NPI 1427420181
  NPD
• Amery Regional Medical Center, Inc.

  • Rural Health Clinic/Center
  • Turtle Lake, WI
  • NPI 1538384466
  NPD (past)

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

• Lakeview Memorial Hospital Association Inc

  • General Acute Care Hospital
  • Stillwater, MN
  • NPI 1538138003
  Care Compare affiliation
• Lakeview Memorial Hospital Association Inc

  • Land Ambulance
  • Stillwater, MN
  • NPI 1730213653

  Hospital

  Care Compare affiliation
• Amery Regional Medical Center, Inc.

  • Critical Access Hospital
  • Amery, WI
  • NPI 1093763518
  Care Compare affiliation
• Amery Regional Medical Center, Inc.

  • Rural Health Clinic/Center
  • Clear Lake, WI
  • NPI 1366878449

  Hospital

  Care Compare affiliation
• Amery Regional Medical Center, Inc.

  • Rural Health Clinic/Center
  • Turtle Lake, WI
  • NPI 1538384466

  Hospital

  Care Compare affiliation
• Amery Regional Medical Center, Inc.

  • Rural Health Clinic/Center
  • Luck, WI
  • NPI 1851345268

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1558740803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N2497 STATE ROAD 58",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "53948",
            "telephone_number": "678-200-3731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CURVE CREST BLVD W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826040",
            "telephone_number": "651-439-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Wabasha St S",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551071805",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 Como Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551081460",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15290 Pennock Ln",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "MN",
            "postal_code": "551247163",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3930 Northwoods Dr",
            "address_purpose": "LOCATION",
            "city": "Arden Hills",
            "state": "MN",
            "postal_code": "551126963",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "265 Griffin St E",
            "address_purpose": "LOCATION",
            "city": "Amery",
            "state": "WI",
            "postal_code": "540011439",
            "country_code": "US",
            "telephone_number": "715-268-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "535 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "New Richmond",
            "state": "WI",
            "postal_code": "540171449",
            "country_code": "US",
            "telephone_number": "715-243-2600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2901 Metro Drive",
            "address_2": "Suite 527",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "55122",
            "country_code": "US",
            "telephone_number": "952-883-5881",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8450 Seasons Pkwy",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551254402",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-20",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "2266",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7270",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Lee Johnson, MA, LPC, LPCC
• Julie Ann Johnson, RN
• Karen E Johnson, CNP
• McKenna Noelle Johnson, PT, DPT
• Nicole Marjorie Johnson
• Sarah Elizabeth Johnson, LAC
• Steven D Johnson, DDS
• Steven D Johnson, MD
• Robert C Jones, LADC
• Hannah Lynn Jonson

• Physician Assistant in Stillwater, MN
• Providers in Stillwater, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.