Douglas Allan Johnson

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

22875 Issued in MN

Practice address

2501 Keenan Dr
International Falls, MN 56649-2181

Phone

(218) 293-9431

Fax

(218) 285-6875

NPI assigned

Jul 7, 2006

Last updated

May 20, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463702400000",
    "number": "1841223708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 KEENAN DR",
            "city": "INTERNATIONAL FALLS",
            "state": "MN",
            "postal_code": "566492181",
            "telephone_number": "218-293-9431",
            "fax_number": "218-285-6875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 KEENAN DR",
            "city": "INTERNATIONAL FALLS",
            "state": "MN",
            "postal_code": "566492181",
            "telephone_number": "218-293-9431",
            "fax_number": "218-285-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DOUGLAS",
        "middle_name": "ALLAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2016-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MN",
            "license": "22875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303363500",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32404500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• International Drug Inc
• International Falls Memorial Hospital
• International Falls Memorial Hospital Association (Rainy Lake Medical Center)
• International Falls Memorial Hospital Association (Rainy Lake Pharmacy)
• International Falls Memorial Hospital Association (Rainy Lake Medical Center)
• Jeanie Johnson, LICSW
• Willard Johnson, PHD, LP
• Linda Kawulia, RPH.
• Heather Nichole Klemetsen, MS, LADC, LPCC
• Jay B Knaak, M.D.

• General Practice Physician in International Falls, MN
• Providers in International Falls, MN by specialty
• General Practice Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.