Susan R Johannsen, CNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

CP000110 Issued in SD

Practice address

1200 S 7TH Ave
Sioux Falls, SD 57105-0900

Phone

(605) 336-2140

Fax

(605) 336-1677

NPI assigned

Aug 11, 2005

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

Medicare fee-for-service enrollment

Enrolled in SD

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, 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.

• Avera McKennan

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sioux Falls, SD
  • NPI 1699009944
  Medicare reassignment
• Avera McKennan

  • Diagnostic Radiology Physician
  • Sioux Falls, SD
  • NPI 1053680678
  NPD
• Avera McKennan

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1376575514

  Physician Assistant

  NPD

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1720080583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86430",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571186430",
            "telephone_number": "605-322-4900",
            "fax_number": "605-322-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S 7TH AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050900",
            "telephone_number": "605-336-2140",
            "fax_number": "605-336-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANNSEN",
        "first_name": "SUSAN",
        "middle_name": "R",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0221",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SD",
            "license": "CP000110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Shaw, DPM, PLLC
• Kathrine A Jibben, PA-C
• Alexandra Job, MD
• Isabelle Joffer, CNP
• Jill Krista Johannsen, DPT
• Christopher K Johansen, MD
• Jennifer Meylann-Chau Johansen
• Logan Johnke, MD
• Austin Johnsen, RPH
• Johnson Chiropractic & Acupuncture

• Gerontology Nurse Practitioner in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Gerontology Nurse Practitioner in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.