Randall D Johnson, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

28405 Issued in MN

Practice address

6500 Excelsior Blvd
St Louis Park, MN 55426-4702

Phone

(952) 993-5391

NPI assigned

Dec 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1588648141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 WAYZATA BLVD",
            "address_2": "STE 315",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 EXCELSIOR BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264702",
            "telephone_number": "952-993-5391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RANDALL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "28405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Elizabeth Johnson, LICSW
• Michael Gene Johnson, DDS
• Michael Joel Johnson, O.D.
• Nicole Johnson, ATC
• Paul G Johnson, M.D.
• Ricia Rae Johnson, OTA/L
• Robert W Johnson, M.D.
• Savannah Johnson
• Shannon Johnson
• Sharon M Johnson, R.D.

• Diagnostic Radiology Physician in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.