Mary J Johnson, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2663 Issued in MN

Practice address

23624 St Francis Blvd
Suite 1
St Francis, MN 55070-0399

Phone

(763) 753-3126

Fax

(763) 753-2808

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Gentle Care Chiropractic

  • Clinic/Center
  • Saint Francis, MN
  • NPI 1447652367
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1710031117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23624 ST. FRANCIS BLVD., STE #1",
            "city": "ST FRANCIS",
            "state": "MN",
            "postal_code": "55070",
            "telephone_number": "763-753-3126",
            "fax_number": "763-753-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23624 ST FRANCIS BLVD",
            "address_2": "SUITE 1",
            "city": "ST FRANCIS",
            "state": "MN",
            "postal_code": "550700399",
            "telephone_number": "763-753-3126",
            "fax_number": "763-753-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCMI",
            "identifier": "231258",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL",
            "identifier": "4K009J0",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS CLINIC",
            "identifier": "4K008J0",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HSM",
            "identifier": "0125",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "4440078",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "817228500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Honesty Home Care LLC
• Kurtis Steven Huether, DDS
• Isd 15 St. Francis Public Schools
• Angelina P Ivanishin
• Lindsey Johnson, RPT
• Michelle Ann Johnson, PHARMD, RPH
• Timothy Mark Johnson, DDS
• Natalie Justin, LGSW
• Jacqueline Jeanne Karpe
• Andrea Knapp

• Chiropractor in St Francis, MN
• Providers in St Francis, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; 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.