Elaine K Johnson, LP, LADC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

67372700 Issued in MN

Practice address

6607 18TH Ave S
Suite 101
Richfield, MN 55423-2784

Phone

(612) 798-7373

Fax

(612) 243-3615

NPI assigned

Feb 21, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• Healtheast Medical Research Institute

  dba HealthEast Vadnais Heights Clinic

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503
  Medicare reassignment NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Fairview Express Care

  • Clinic/Center
  • Saint Paul, MN
  • NPI 1275277204
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Fairview Health Services

  dba Fairview Hospital University

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD
• Fairview Health Services

  dba Fairview Emergency Medical Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• Healtheast Medical Research Institute

  dba M Health Fairview Specialty Clinic Beam

  • Clinic/Center
  • Maplewood, MN
  • NPI 1164154316
  NPD
• Healtheast Medical Research Institute

  dba HealthEast Professional Services

  • Internal Medicine Physician
  • Saint Paul, MN
  • NPI 1508191552

  Psychologist

  NPD

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750426979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6607 18TH AVE S",
            "address_2": "SUITE 101",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232784",
            "telephone_number": "612-798-7373",
            "fax_number": "612-243-3615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6607 18TH AVE S",
            "address_2": "SUITE 101",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232784",
            "telephone_number": "612-798-7373",
            "fax_number": "612-243-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ELAINE",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "LP, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "67372700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN HEALTHCARE PROGRAM NO.",
            "identifier": "67372700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Parvathi Jithendranathan, DDS
• Joann C Boraas, DDS, PA
• Anne Christine Johnson, MSW, LICSW
• Claire Johnson, OTD
• Donald Allen Johnson, DDS
• Jan Marie Johnson, LICSW
• Mark Joseph Johnson, DDS
• Mark Steven Johnson, D.D.S.
• Ashley Sherelle Jones
• Nicole Shenea Jones

• Psychologist in Richfield, MN
• Providers in Richfield, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.