Individual provider Active NPI

Kasey E Johnson, D.O.

  • Psychiatry Physician
  • Fargo, ND
National Provider Identifier
1801173893
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
80886 Issued in MN
Practice address
1919 Elm St N
Fargo, ND 58102-2416
Phone
(701) 293-4113
Fax
(701) 293-4109
NPI assigned
Nov 4, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 80886 MN Primary
Social Worker 104100000X
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X RL17452 ND

Addresses

Primary practice location

1919 Elm St N
Fargo, ND 58102-2416

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (701) 293-4113

Other practice location 1

915 Anderson Dr
Aberdeen, WA 98520
Phone (360) 537-5112

Other practice location 2

1705 Anne St NW
Bemidji, MN 56601-6151
Phone (218) 333-5000

Other practice location 3

400 NE 7th St
Gresham, OR 97030-5604
Phone (503) 661-5455

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL kasey.johnson.1@und.edu Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260429000339 MN Practitioner - Psychiatry 5698242592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Pacific NW Un of HS, Col of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-5000

1705 Anne St NW
Bemidji, MN 56601-6151
Phone (218) 333-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80886MNMDPsychiatry Physician
RL17452NDMDStudent in an Organized Health Care Education/Training Program

Organizations & group practices 1

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 2

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": "1320364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1801173893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "701-293-4113",
            "fax_number": "701-293-4109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 ELM ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581022416",
            "telephone_number": "701-293-4113",
            "fax_number": "701-293-4109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 Anderson Dr",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "WA",
            "postal_code": "98520",
            "country_code": "US",
            "telephone_number": "360-537-5112",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1705 Anne St NW",
            "address_purpose": "LOCATION",
            "city": "Bemidji",
            "state": "MN",
            "postal_code": "566016151",
            "country_code": "US",
            "telephone_number": "218-333-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 NE 7th St",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970305604",
            "country_code": "US",
            "telephone_number": "503-661-5455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KASEY",
        "middle_name": "E",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-04",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "80886",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ND",
            "license": "RL17452",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "kasey.johnson.1@und.edu",
            "affiliation": "N",
            "endpointDescription": "professional email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1919 Elm St N",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581022416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.