Amanda Nycol Johnson, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

8495 Issued in MN

Practice address

5703 Lachman Ave NE
Albertville, MN 55301-3973

Phone

(763) 284-1877

Fax

(763) 205-5834

NPI assigned

Sep 7, 2021

Last updated

Oct 6, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Amanda Preston Former name

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lorenz Clinic LLCGroup PAC ID 7810282845, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Master of Science - Nursing

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.preston.1@16506.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/16506/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Evernorth Clinic, PLLC

  • Adolescent and Children Mental Health Clinic/Center
  • Albertville, MN
  • NPI 1053116483
  Medicare reassignment NPD Authorized official
• Lorenz Clinic, LLC

  • Marriage & Family Therapist
  • Victoria, MN
  • NPI 1982900510
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1851060636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1772 STIEGER LAKE LN STE 220",
            "city": "VICTORIA",
            "state": "MN",
            "postal_code": "553867720",
            "telephone_number": "952-443-4600",
            "fax_number": "952-443-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5703 LACHMAN AVE NE",
            "city": "ALBERTVILLE",
            "state": "MN",
            "postal_code": "553013973",
            "telephone_number": "763-284-1877",
            "fax_number": "763-205-5834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1772 Stieger Lake Ln Ste 220",
            "address_purpose": "LOCATION",
            "city": "Victoria",
            "state": "MN",
            "postal_code": "553867720",
            "country_code": "US",
            "telephone_number": "952-443-4600",
            "fax_number": "952-443-4604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMANDA",
        "middle_name": "NYCOL",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "8495",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "8495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "PRESTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lori Hunt
• Ideal Home Assessments
• Ife - MN, Inc (Albertville Eye Care)
• Independent School District #885 (St. Michael - Albertville Schools)
• Michelle Lee Jerdin
• Benjamin Nord Johnson, CMT
• Sarah Elizabeth Jones-Witthuhn, DDS
• Joynest Services LLC
• Haley Kampf
• Jennifer Kessler

• Pediatric Nurse Practitioner in Albertville, MN
• Providers in Albertville, MN by specialty
• Pediatric Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.