Active NPI
Curt L Johnson, PHD LP
- Clinical Psychologist
- Saint Cloud, MN
National Provider Identifier
1871503995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1517
- Practice address
- 4801 Veterans Dr
St Cloud VA Medical Center
Saint Cloud, MN 56303-2015 - Phone
- (218) 839-4785
- Fax
- (218) 829-9555
- NPI assigned
- Aug 9, 2006
- Sex
- Male
- 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 | 1517 | MN | Primary |
Addresses
Primary practice location
4801 Veterans Dr
St Cloud VA Medical Center
Saint Cloud, MN 56303-2015
Mailing address
4801 Veterans Dr
St Cloud VA Medical Center
Saint Cloud, MN 56303-2015
Phone (218) 839-4785
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 62G70JO | Other | MN | BCBS |
| 6101305 | Other | MN | MEDICA |
| 633252800 | Medicaid | MN | |
| 850261 | Other | MN | ARAZ |
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 |
|---|---|---|---|
| 1517 | MN | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Core Professional Services, P.a. | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262736000000",
"number": "1871503995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4801 VETERANS DR",
"address_2": "ST CLOUD VA MEDICAL CENTER",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563032015",
"telephone_number": "218-839-4785",
"fax_number": "218-829-9555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 VETERANS DR",
"address_2": "ST CLOUD VA MEDICAL CENTER",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563032015",
"telephone_number": "218-839-4785",
"fax_number": "218-829-9555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "CURT",
"middle_name": "L",
"credential": "PHD LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2010-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "1517",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "62G70JO",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "6101305",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "633252800",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ",
"identifier": "850261",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.