Individual provider Active NPI

Susan Catherine Johnson

  • Family Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1821750753
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8605 Issued in MN
Practice address
2530 Chicago Ave Ste 550
Minneapolis, MN 55404-4293
Phone
(612) 813-8000
NPI assigned
Oct 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8605 MN Primary

Addresses

Primary practice location

2530 Chicago Ave Ste 550
Minneapolis, MN 55404-4293

Mailing address

2530 Chicago Ave Ste 550
Minneapolis, MN 55404-4293
Phone (612) 813-8000

Other names 1

  • Susan Catherine Wehmhoff Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211217001129 MN Practitioner - Nurse Practitioner 5991196453 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8605MNMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Surgical Associates LTD CurrentSince Sep 27, 2021 Accepting new patients
Gillette Children'S Specialty Healthcare PastSince Sep 27, 2021 Accepting new patients

Locations

2530 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

4530 77th St W
Ste 205
Minneapolis, MN 55435
Phone (952) 835-3375

2530 Chicago Ave
Ste 550
Minneapolis, MN 55404
Phone (612) 810-8000

5354 Edgewood Dr
Saint Paul, MN 55112

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1821750753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE STE 550",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044293",
            "telephone_number": "612-813-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE STE 550",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044293",
            "telephone_number": "612-813-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SUSAN",
        "middle_name": "CATHERINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "8605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "WEHMHOFF",
            "middle_name": "CATHERINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.