Jane Johnson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3799 Issued in ND

Practice address

2405 8TH St S Ste 200
Moorhead, MN 56560-4200

Phone

(218) 380-7357

Fax

(218) 331-4867

NPI assigned

Sep 1, 2017

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

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 Social Worker

Education

University of North Dakota School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nystrom and Associates LTDGroup PAC ID 6406752492, 590 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.

• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment Care Compare group NPD
• Family Support Services Inc.

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD

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

{
    "created_epoch": "1504224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1992223697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 BIRCH LN",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565603226",
            "telephone_number": "218-236-1783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 8TH ST S STE 200",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565604200",
            "telephone_number": "218-380-7357",
            "fax_number": "218-331-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-01",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "11062",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "3799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Jensen
• Jessica L. Hardy, DDS, PA
• Jimpat Inc
• Aaron Johnson
• Bria Johnson
• Julie Michele Johnson, MS CCC-SLP
• Karen A Johnson, LMFT
• Karliann K Johnson, LPCC
• Kent Johnson
• McKenzie Johnson

• Clinical Social Worker in Moorhead, MN
• Providers in Moorhead, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.