Active NPI
Heidi J Johnston, CTRS
- Recreation Therapist
- Minneapolis, MN
National Provider Identifier
1912955659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 52488
- Practice address
- 3915 Golden Valley Rd
Courage Center
Minneapolis, MN 55422-4249 - Phone
- (763) 520-0687
- Fax
- (763) 520-0355
- NPI assigned
- May 5, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 52488 | WI | Primary |
Addresses
Primary practice location
3915 Golden Valley Rd
Courage Center
Minneapolis, MN 55422-4249
Mailing address
3915 Golden Valley Rd
Courage Center
Minneapolis, MN 55422-4249
Phone (763) 520-0687
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52488 | WI | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216944000000",
"number": "1912955659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3915 GOLDEN VALLEY RD",
"address_2": "COURAGE CENTER",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554224249",
"telephone_number": "763-520-0687",
"fax_number": "763-520-0355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3915 GOLDEN VALLEY RD",
"address_2": "COURAGE CENTER",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554224249",
"telephone_number": "763-520-0687",
"fax_number": "763-520-0355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "HEIDI",
"middle_name": "J",
"credential": "CTRS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-05",
"last_updated": "2008-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "WI",
"license": "52488",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.