NIKOLENE JOHNSON (NPI# 1104363993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104363993 |
| Entity Type | Individual |
| Full Name | NIKOLENE JOHNSON |
| Practice Address |
7920 Old Cedar Ave S Bloomington MN 55425-1207 |
| Practice Telephone | 6512411800 |
| Mailing Telephone | 6512411800 |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2019-03-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1104363993 | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 363A00000X | Physician Assistant | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
7920 OLD CEDAR AVE S |
| City | BLOOMINGTON |
| State | MN |
| Zip Code | 55425-1207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841277043 | Kent K Bratten | Internal Medicine | 7920 Old Cedar Ave S, Bloomington, MN 55425-1207 | 2005-12-28 |
| 1326652256 | Amy Rebecca Hurst | Midwife | 7920 Old Cedar Ave S, Bloomington, MN 55425-1207 | 2020-09-08 |
| 1174032981 | Matt Kresl | Pharmacist | 7920 Old Cedar Ave S, Bloomington, MN 55425-1207 | 2017-09-25 |
| 1417471418 | Britta Victoria Kasmarik | Nurse Practitioner | 7920 Old Cedar Ave S, Bloomington, MN 55425-1207 | 2017-08-01 |
| 1568824563 | Hilary C Gerten | Psychiatry & Neurology | 7920 Old Cedar Ave S, Bloomington, MN 55425-1207 | 2016-03-28 |
| 1275914020 | Jaclyn Rose Guetzko | Nurse Practitioner | 7920 Old Cedar Ave S, Bloomington, MN 55425-1207 | 2015-06-17 |
| 1407236599 | Alesha N Roach | Obstetrics & Gynecology | 7920 Old Cedar Ave S, Bloomington, MN 55425-1207 | 2015-06-03 |
| 1013213891 | Allina Health System | Clinic/Center | 7920 Old Cedar Ave S, Bloomington, MN 55425-1207 | 2011-01-27 |
| 1003066168 | Julia Braden Reitz | Audiologist-Hearing Aid Fitter | 7920 Old Cedar Ave S, Bloomington, MN 55425-1207 | 2008-09-25 |
| 1144489618 | Elizabeth Kim Farhat | Dermatology | 7920 Old Cedar Ave S, Bloomington, MN 55425-1207 | 2008-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275132003 | Faizo A Hersi | Student in an Organized Health Care Education/Training Program | 9700 International Dr Suite 300, Bloomington, MN 55425 | 2020-10-22 |
| 1134773419 | Fairview Clinics | Clinic/Center | 322 E. Broadway Suite E322, Bloomington, MN 55425 | 2019-07-25 |
| 1548730328 | Che Doua Thao | Pharmacy Technician | Leafline Labs, Eagan, MN 55425 | 2018-12-05 |
| 1235645763 | Caringhands Adult Day Center | Chore Provider | 8040 Old Cedar Ave South Suite # 1, Bloomington, MN 55425 | 2017-12-20 |
| 1174044119 | Abs Holdings, Inc. | In Home Supportive Care | 2626 East 82nd St., Suite 145, Bloomington, MN 55425 | 2017-06-29 |
| 1598144891 | Matthew Runde | Family Medicine | Riverway Clinic Anoka 601 Jacob Lane, Anoka, MN 55425 | 2015-05-20 |
| 1336578145 | Rebecca Ann Lund | Counselor | 8011 34th Avenue South, Suite 206, Bloomington, MN 55425 | 2013-11-02 |
| 1578902250 | Promise Care, Inc | Home Health | 7900 International Drive, Suite 300, Bloomington, MN 55425 | 2013-06-17 |
| 1336292911 | Gane Marie Boothroyd | Optometrist | 304 N. Garden, Mall of America, Bloomington, MN 55425 | 2007-01-18 |
| 1841341898 | Visual Edge, Inc | Technician/Technologist | W 385 West Market, Mall of America, Bloomington, MN 55425 | 2007-01-16 |
| Find all providers in zip 55425 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508496621 | Samantha Jean Mcgough Lamere | Physician Assistant | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 | 2020-01-16 |
| 1386292886 | Quinn Harmon | Physician Assistant | 1310 W Bloomfield Rd Ste C, Bloomington, IN 47403-2001 | 2019-08-28 |
| 1568973717 | Gregory Thomas Dougan | Physician Assistant | 418 South Landmark Avenue, Bloomington, IN 47403 | 2017-10-16 |
| 1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
| 1730619487 | Elise Nicole Lill | Physician Assistant | 4300 Market Pte Dr Ste 100, Bloomington, MN 55435-5435 | 2017-06-15 |
| 1528417557 | Kathryn Shalbrack | Physician Assistant | 4300 Marketpointe Dr, Bloomington, MN 55435-5423 | 2016-06-09 |
| 1740634203 | Alfonso Luna IIi | Physician Assistant | 657 S Lancewood Ave, Bloomington, CA 92316-1336 | 2016-04-20 |
| 1215308671 | Sara Ann Houk | Physician Assistant | 2200 E. Washington St, Bloomington, IL 61701-4323 | 2015-10-12 |
| 1760865133 | Patrick D Machacek | Physician Assistant | 10633 Vincent Ave S, Bloomington, MN 55431-3733 | 2015-07-03 |
| 1558740803 | Samuel Johnson | Physician Assistant | 2901 Metro Drive, Suite 527, Bloomington, MN 55122 | 2015-05-20 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 55425 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.