NPIMap

Individual provider Active NPI

Eric Austin Johnson, M.D.

  • Psychiatry Physician
  • Duluth, MN
National Provider Identifier
1750464640
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
41189 Issued in MN
Practice address
202 N 24TH Ave E
Duluth, MN 55812-1859
Phone
(320) 983-5728
Fax
(218) 481-0325
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 41189 MN Primary

Addresses

Primary practice location

202 N 24TH Ave E
Duluth, MN 55812-1859

Mailing address

202 N 24TH Ave E
Duluth, MN 55812-1859
Phone (320) 983-5728

Other practice location 1

925 E Superior St Ste 106
Duluth, MN 55802-2253
Phone (218) 481-0220

Other identifiers 1

IdentifierTypeStateIssuer
703522500MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20040713001027 MN Practitioner - Psychiatry 5991783185 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Medical University of South Carolina College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians
Duluthtms LLCGroup PAC ID 0749558104, 3 clinicians

Practice addresses (Care Compare)

13045 Falcon Dr
Suite 100
Baxter, MN 56425-4201
Phone (218) 829-9307

202 N 24TH Ave E
Duluth, MN 55812-1859
Phone (218) 481-0220

Hospital & facility affiliations

  • Aspirus Wausau Hospital Hospital, Wausau, WI, CCN 520030

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Cloud TMS LLC Current Accepting new patients
Duluthtms, LLC Psychiatry CurrentSince May 24, 2017 Accepting new patients
Nystrom & Associates, LTD CurrentSince Apr 16, 2007 Accepting new patients
Family Support Services Inc. Past Accepting new patients
Allina Health System Past Accepting new patients
Bio-Medical Applications of Minnesota, Inc. Past Accepting new patients

Locations

207 Jefferson Blvd
Big Lake, MN 55309
Phone (763) 367-6080

13045 Falcon Dr
#100
Brainerd, MN 56425
Phone (218) 203-6282

925 E Superior St
Ste 106
Duluth, MN 55802
Phone (218) 249-6230

3333 W Division St
Ste 215
Saint Cloud, MN 56301

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

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.

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1750464640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 N 24TH AVE E",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558121859",
            "telephone_number": "320-983-5728",
            "fax_number": "218-481-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N 24TH AVE E",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558121859",
            "telephone_number": "320-983-5728",
            "fax_number": "218-481-0325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 E Superior St Ste 106",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558022253",
            "country_code": "US",
            "telephone_number": "218-481-0220",
            "fax_number": "218-481-0325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ERIC",
        "middle_name": "AUSTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "41189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "703522500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.