Active NPI
Donna Johnson, PH.D., LP
- Clinical Psychologist
- Saint Paul, MN
National Provider Identifier
1811901093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3958
- Practice address
- 1919 University Ave W Ste 200
Saint Paul, MN 55104-3435 - Phone
- (651) 266-7999
- NPI assigned
- Jul 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3958 | MN | Primary |
Addresses
Primary practice location
1919 University Ave W Ste 200
Saint Paul, MN 55104-3435
Mailing address
1057 Cobb Rd
Shoreview, MN 55126-8121
Phone (612) 803-3737
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41Q23JO | Other | MN | BCBS |
| 122753 | Other | MN | UC |
| 292827200 | Medicaid | MN | |
| 1016381 | Other | MN | P1 |
| 134814 | Other | MN | CP |
| 26291 | Other | MN | HP |
| 61-53007 | Other | FM | UBH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3958 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507507200000",
"number": "1811901093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1057 COBB RD",
"city": "SHOREVIEW",
"state": "MN",
"postal_code": "551268121",
"telephone_number": "612-803-3737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 UNIVERSITY AVE W STE 200",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551043435",
"telephone_number": "651-266-7999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "DONNA",
"name_prefix": "Dr.",
"credential": "PH.D., LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2017-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "3958",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "41Q23JO",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UC",
"identifier": "122753",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "292827200",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "P1",
"identifier": "1016381",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CP",
"identifier": "134814",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HP",
"identifier": "26291",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH",
"identifier": "61-53007",
"state": "FM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.