Kristen Aili Johnson, PMHNP-BC, FNP-C
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Grand Forks, ND
NPI 1629679782 · NPPES record last updated Apr 13, 2026
Key facts
- NPI
- 1629679782
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- R53273 (ND)
- Practice address
- 3674 S Washington St
Grand Forks, ND 58201 - Phone
- (701) 205-3000
- NPI assigned
- Nov 5, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 34
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Peterson Medical Clinics LLC
Kenaitze Indian Tribe
Bristol Bay Area Health Corporation
Practice addresses (Care Compare)
205 E Benson Blvd
Suite 401
Anchorage, AK 99503-4019
Phone (701) 205-3000
4501 15TH Ave SW
Suite 105
Fargo, ND 58103-8956
Phone (701) 205-3000
508 Upland St
Kenai, AK 99611-8026
Phone (907) 335-7500
519 Anne St NW
Suite a
Bemidji, MN 56601-4277
Phone (701) 205-3000
6000 Kanakanak Rd
Dillingham, AK 99576-0130
Phone (907) 842-5201
7717 Venice Dr
Abilene, TX 79606-6694
Phone (701) 205-3000
960 S 24TH St W
Suite H
Billings, MT 59102-6450
Phone (701) 205-3000
P O Box
Dillingham, AK 99576-0130
PO Box
Suite 130
Dillingham, AK 99576-0130
Phone (907) 842-5201
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (5 enrollments) in TX, ND, AK, MN, MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210602001245 | TX | Practitioner - Nurse Practitioner | 6608275284 | Reassigns benefits to 3 organizations |
| I20221013003322 | ND | Practitioner - Nurse Practitioner | 6608275284 | Reassigns benefits to 1 organization |
| I20221205002891 | AK | Practitioner - Nurse Practitioner | 6608275284 | Reassigns benefits to 4 organizations |
| I20230524000349 | MN | Practitioner - Nurse Practitioner | 6608275284 | Reassigns benefits to 1 organization |
| I20251121000056 | MT | Practitioner - Nurse Practitioner | 6608275284 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10233 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bristol Bay Area Health Corportion | Current | Accepting new patients | |
| Eastern Aleutian Tribes, Inc | Current |
Accepting new patients | |
| Kenaitze Indian Tribe | Current | Accepting new patients | |
| Bristol Bay Area Health Corporation | Current | Accepting new patients | |
| Bristol Bay Area Health Corporation | Current | Accepting new patients | |
| Bristol Bay Area Health Corporation | Current | Accepting new patients | |
| Center for Psychiatric Care | Current |
Accepting new patients | |
| Bristol Bay Area Health Corporation | Current | Accepting new patients | |
| Norton Sound Health Corporation | Current | Accepting new patients | |
| Bristol Bay Area Health Corporation | Current |
Accepting new patients | |
| Bristol Bay Area Health Corporation | Current | Accepting new patients | |
| Bristol Bay Area Health Corporation | Current | Accepting new patients | |
| Bristol Bay Area Health Corportation | Current | Accepting new patients | |
| Bristol Bay Area Health Corporation | Current | Accepting new patients | |
| Norton Sound Health Corporation | Current |
Accepting new patients | |
| Bristol Bay Area Health Corporation | Current | Accepting new patients | |
| Kenaitze Indian Tribe | Current |
Accepting new patients | |
| Bristol Bay Area Health Corporation | Current | Accepting new patients | |
| Norton Sound Health Corporation | Current |
Accepting new patients | |
| Bristol Bay Area Health Corporation | Current | Accepting new patients | |
| Bristol Bay Area Health Corporation | Current | Accepting new patients | |
| Bristol Bay Area Health Corporation | Current | Accepting new patients | |
| Bristol Bay Area Health Corporation | Current | Accepting new patients | |
| Bristol Bay Area Health Corporation | Current |
Accepting new patients | |
| Bristol Bay Area Health Corporation | Current | Accepting new patients | |
| Bristol Bay Area Health Corporation | Current | Accepting new patients | |
| Bristol Bay Area Health Corportion | Current | Accepting new patients | |
| Lake Country Associates, Inc. | Past |
Accepting new patients | |
| Southwestern Dist Health Unit | Past | Accepting new patients | |
| Sweet Memorial Nursing Home | Past |
Accepting new patients | |
| Eastern Aleutian Tribes, Inc | Past | Accepting new patients |
Locations
3380 C St
Ste 100
Anchorage, AK 99503
Phone (907) 277-1440
3380 C St
Ste 107
Anchorage, AK 99503
Phone (907) 277-1440
508 Upland St
Kenai, AK 99611
Phone (907) 335-7300
1202 23rd St S
Ste 3
Fargo, ND 58103
Phone (701) 478-7887
Interoperability endpoints
- kajohnson@direct.nshcorp.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R53273 | ND | Yes |
Addresses
Primary practice location
3674 S Washington St
Grand Forks, ND 58201
Mailing address
PO Box 84101
Seattle, WA 98124-5401
Phone (907) 335-7500
Other practice location 1
206 W Rockwell Ave
Soldotna, AK 99669-7439
Phone (907) 335-7500
Other practice location 2
508 Upland St
Kenai, AK 99611-8026
Phone (907) 335-7500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q00086344 | Other | RR PTAN | |
| 1733819 | Medicaid | AK | |
| 15154247 | Other | CAQH |
Other providers in Grand Forks, ND
- Eric L Johnson
- Jennifer Eileen Johnson
- Joel L Johnson
- Joshua Johnson
- Katrina Johnson
- Kristine Beth Johnson
- Mandi Lynn Johnson
- Melissa Leigh Johnson
- Renae Elizabeth Johnson
- Robert A Johnson
All providers in Grand Forks, ND · Psychiatric/Mental Health Nurse Practitioner in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.