NPIMap

Individual provider Active NPI

Jeffrey A Johnson, MD

  • Family Medicine Physician
  • Yankton, SD
National Provider Identifier
1750360202
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4647 Issued in SD
Practice address
2525 Fox Run Pkwy
Ste 200
Yankton, SD 57078-5370
Phone
(605) 260-2100
Fax
(605) 260-2104
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4647 SD Primary

Addresses

Primary practice location

2525 Fox Run Pkwy
Ste 200
Yankton, SD 57078-5370

Mailing address

2525 Fox Run Pkwy
Ste 200
Yankton, SD 57078-5370
Phone (605) 260-2100

Other identifiers 1

IdentifierTypeStateIssuer
5609960MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040508000448 SD Practitioner - Family Practice 5294724845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Sanford School of Medicine of University of South Dakota, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health Services 151 clinicians

Practice addresses (Care Compare)

2525 Fox Run Pkwy
Suite 200
Yankton, SD 57078-5371
Phone (605) 260-2100

Hospital & facility affiliations

  • Avera @ Home Home health agency, Yankton, SD, CCN 437006
  • Avera @ Home Hospice, Yankton, SD, CCN 431505
  • Avera Sacred Heart Hospital Hospital, Yankton, SD, CCN 430012
  • St Michael'S Hospital - Cah Hospital, Tyndall, SD, CCN 431327
  • Avera Sister James Care Center Nursing home, Yankton, SD, CCN 435070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4647SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health Services Family Medicine CurrentSince Apr 1, 2017 Accepting new patients
Sacred Heart Health Services Current Accepting new patients
Sacred Heart Health Services CurrentSince Apr 1, 2017 Accepting new patients
Lincoln Medical Education Partnership Family Medicine Past Accepting new patients
Sacred Heart Health Services Past Accepting new patients

Locations

2525 Fox Run Pkwy
Ste 200
Yankton, SD 57078
Phone (605) 260-2100

501 Summit St
Yankton, SD 57078
Phone (605) 655-1201

Interoperability endpoints

  • Direct secure messaging: jeffrey.johnson1@avera.sdhealthlink.net

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1750360202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 FOX RUN PKWY",
            "address_2": "STE 200",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570785370",
            "telephone_number": "605-260-2100",
            "fax_number": "605-260-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 FOX RUN PKWY",
            "address_2": "STE 200",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570785370",
            "telephone_number": "605-260-2100",
            "fax_number": "605-260-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "4647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5609960",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yankton, SD

Sources for this page

Verify at the official NPI Registry.