Individual provider Active NPI

Ashley Keryn Johnson, DNP, RN, ANP-C

  • Adult Health Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1982999397
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R160709-1 Issued in MN
Practice address
909 Fulton St SE
Minneapolis, MN 55455-4800
Phone
(612) 676-5008
Fax
(612) 676-5024
NPI assigned
Jun 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP4095 AZ
Adult Health Nurse Practitioner 363LA2200X R160709-1 MN Primary

Addresses

Primary practice location

909 Fulton St SE
Minneapolis, MN 55455-4800

Mailing address

10432 Quebec Ave S
Bloomington, MN 55438-2137
Phone (480) 221-3321

Other names 1

  • Ashley Keryn McCabe Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130814000958 MN Practitioner - Nurse Practitioner 7416127097 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.33 of 100Reported as group
Quality
93.68
Promoting interoperability
100
Improvement activities
40
Cost
70.75

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
79.17
Promoting interoperability
100
Improvement activities
40
Cost
73.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP4095AZMDAdult Health Nurse Practitioner
R160709-1MNMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Aug 23, 2013 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
University of Minnesota Physicians CurrentSince Sep 19, 2016 Accepting new patients
Fairview Health Services CurrentSince Aug 23, 2013 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Sep 19, 2016 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services Current Accepting new patients
Matrix Medical Plus CurrentSince Feb 1, 2023 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Sep 19, 2016 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

121 Washington Ave N
Fl 4
Minneapolis, MN 55401
Phone (404) 992-2702

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

Interoperability endpoints

  • Direct secure messaging: ajohnson301375@fairview.direct-ci.com

Organizations & group practices 12

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1982999397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10432 QUEBEC AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554382137",
            "telephone_number": "480-221-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 FULTON ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554554800",
            "telephone_number": "612-676-5008",
            "fax_number": "612-676-5024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ASHLEY",
        "middle_name": "KERYN",
        "name_prefix": "Dr.",
        "credential": "DNP, RN, ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP4095",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "R160709-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "MCCABE",
            "middle_name": "KERYN",
            "credential": "DNP, ANP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.