Mary Jo Johnson, CNM, CNP

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

R123626-8 Issued in MN

Practice address

3625 W 65TH St Ste 100
Edina, MN 55435-2147

Phone

(952) 920-7001

NPI assigned

Sep 30, 2005

Last updated

Feb 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

University of Minnesota Medical School, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier OBGYN of Minnesota PLLCGroup PAC ID 1355396110, 88 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

Merit-based Incentive Payment System (MIPS)

Final score

87.24 of 100Reported as group

Quality

86.35

Promoting interoperability

100

Improvement activities

40

Cost

71.1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Certified Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.johnson.1@20897.direct.athenahealth.com

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.

• Premier OBGYN of Minnesota PLLC

  • Obstetrics & Gynecology Physician
  • Edina, MN
  • NPI 1801946223
  Medicare reassignment Care Compare group NPD
• Fairview Clinics

  dba Fairview Clinics-Hiawatha

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Fairview Clinics

  dba M Health Fairview Clinic - Hugo

  • Primary Care Clinic/Center
  • Hugo, MN
  • NPI 1518111772
  NPD
• Fairview Clinics

  dba Fairview Clinics-Apple Valley

  • Primary Care Clinic/Center
  • Apple Valley, MN
  • NPI 1649462508
  NPD
• Fairview Health Services

  dba Fairview Hospital University

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD
• Fairview Health Services

  dba Fairview Emergency Medical Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• Fairview Health Services

  dba Fairview Ridges Hospital

  • General Acute Care Hospital
  • Burnsville, MN
  • NPI 1245217520
  NPD (past)

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

• Fairview Health Services

  dba Fairview Hospital University

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  dba Fairview Diagnostic Laboratory

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1316008212
  Care Compare affiliation
• Fairview Health Services

  dba University of MN Medical Center, Fairview Transitional Care

  • Skilled Nursing Facility
  • Minneapolis, MN
  • NPI 1669459913

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1578550992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15014 BRIDGEWATER DR",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553785618",
            "telephone_number": "218-340-7369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 W 65TH ST STE 100",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352147",
            "telephone_number": "952-920-7001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "927 Trettel Ln",
            "address_purpose": "LOCATION",
            "city": "Cloquet",
            "state": "MN",
            "postal_code": "557201345",
            "country_code": "US",
            "telephone_number": "218-879-1227 x2169",
            "fax_number": "218-878-2136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "CNM, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R123626-8",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "R123626-8",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "642215200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda C Johnson, M.D.
• Lisa Dawn Johnson, RN
• Madeline K Johnson, PA-C
• Mary Alycia Johnson
• Mary Elizabeth Johnson, D.D.S.
• Matthew Tyler Johnson, LICSW
• Megan Pamela Johnson, PA-C
• Melissa Michelle Johnson, PSY.D. LP.
• Melissa Roedel Johnson, MD
• Natalie Johnson, LPCC

• Advanced Practice Midwife in Edina, MN
• Providers in Edina, MN by specialty
• Advanced Practice Midwife in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.