Frederick W Johnson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

19185 Issued in MN

Practice address

500 Osborne Rd NE
Suite 200
Fridley, MN 55432-2765

Phone

(763) 236-2045

Fax

(763) 236-2044

NPI assigned

Oct 4, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1740375971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 OSBORNE RD NE",
            "address_2": "SUITE 200",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554322765",
            "telephone_number": "763-236-2045",
            "fax_number": "763-236-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "FREDERICK",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "19185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "670892700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paula Jean Johns, RN
• Amber M Johnson, PA
• Ann Serbus Johnson, PT
• Daniel Johnson
• Donald Edward Johnson, M.D.
• Iris E. Johnson, MA, CCC-A
• Judy Joann Johnson, OPTICAN
• Katrina Johnson
• Matthew Michael Johnson, DO
• Megan Johnson, MA, LPCC

• Surgery Physician in Fridley, MN
• Providers in Fridley, MN by specialty
• Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.