Rori Joanna Johnson, PSYD LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP4478 Issued in MN

Practice address

5842 Old Main St Ste 2
North Branch, MN 55056-6698

Phone

(651) 401-3061

Fax

(651) 674-2534

NPI assigned

Feb 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Canvas Health IncGroup PAC ID 8729073978, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Canvas Health, Inc.

  • Mental Health Counselor
  • Oakdale, MN
  • NPI 1922051325

  MN

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1861531998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5842 OLD MAIN ST STE 2",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550566698",
            "telephone_number": "651-401-3061",
            "fax_number": "651-674-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5842 OLD MAIN ST STE 2",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550566698",
            "telephone_number": "651-401-3061",
            "fax_number": "651-674-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RORI",
        "middle_name": "JOANNA",
        "credential": "PSYD LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP4478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry'S Enterprises, Inc
• Annie Johansson
• Cara Johnson, M.S., MFT
• Debbie Rae Johnson, LADC, LPCC
• Maggie Florence Johnson, LPCC
• Eve Marie Kaldahl, LPC
• Koski Consulting
• William John Koski, LISW
• Amanda Jean Kremers, DNP
• Jena Marie Labine, NP

• All providers in North Branch, MN
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.