DR. MATTHEW SANDER JOHNSON (NPI# 1558593004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558593004 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW SANDER JOHNSON |
| Credential | M.D. |
| Practice Address |
3777 Coon Rapids Blvd Nw Suite 100 Coon Rapids MN 55433 |
| Practice Telephone | 7634217420 |
| Practice Fax Number | 7635928453 |
| Mailing Telephone | 7634217420 |
| Mailing Fax Number | 7635928453 |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2013-07-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | 28337 | OK | Allopathic & Osteopathic Physicians |
| Y | 207W00000X | Ophthalmology | 20373 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | RESIDENCY PERMIT NUMBER | 20373 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336706514 | Matthew Thomas Johnson | Counselor | 4643 American Legion Rd Se, Iowa City, IA 52240-9057 | 2019-05-23 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1023523016 | Matthew Johnson | Specialist/Technologist | 51 Armstrong Rd, Enfield, CT 06082-2731 | 2017-12-12 |
| 1881105914 | Matthew Alan Johnson | Optometrist | 360 Merrimack St Bldg 91, Lawrence, MA 01843-1740 | 2017-10-16 |
| 1801324991 | Matthew Allen Johnson | Psychologist | 1812 Sumner Ave Ste 1, Aberdeen, WA 98520-4602 | 2017-06-01 |
| 1306377288 | Matthew Johnson | Specialist/Technologist | 713 Mill Grove Dr, Audubon, PA 19403 | 2017-03-23 |
| 1386026003 | Matthew Johnson | Dentist | 72 Ashe St Apt A, Charleston, SC 29403-5964 | 2015-06-18 |
| 1992183057 | Matthew Johnson | Specialist/Technologist | 18220 San Lucas Ct, Brookfield, WI 53045-3870 | 2015-05-11 |
| 1487058582 | Matthew John Johnson | Specialist/Technologist | 27 Whittier Dr, Greenlawn, NY 11740-2609 | 2014-10-17 |
| 1265845945 | Matthew Johnson | Behavioral Analyst | 504 S Hays Ave Apt 5, Carbondale, IL 62901-2631 | 2014-06-10 |
| Street Address |
3777 COON RAPIDS BLVD NW SUITE 100 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083617849 | James Adair Cameron | Ophthalmology | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433 | 2005-05-24 |
| 1568873123 | Becky Yeung | Optometrist | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433-2630 | 2014-05-16 |
| 1588005300 | Bio-medical Applications of Minnesota, Inc. | Clinic/Center | 3777 Coon Rapids Blvd Nw, Ste 120, Coon Rapids, MN 55433-2630 | 2013-07-09 |
| 1285918268 | Paul Chadima Hammond | Optometrist | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433-2630 | 2011-10-07 |
| 1891924304 | Marlene Kluss | Optometrist | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433 | 2009-07-06 |
| 1912151929 | David V Folden | Ophthalmology | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433 | 2008-11-05 |
| 1730386723 | North Suburban Optical | Eyewear Supplier (Equipment, not the service) | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433 | 2007-07-02 |
| 1407903248 | Edina Eye Physicians and Surgeons Pa | Clinic/Center | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433 | 2007-01-04 |
| 1073542767 | Bridget C Axelson | Optometrist | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433 | 2006-07-03 |
| 1205870045 | Mark Lobanoff | Ophthalmology | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433 | 2006-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083935068 | George Randall Wandling Jr. | Ophthalmology | 3777 Coon Rapids Blvd Nw # 100, Coon Rapids, MN 55433-2630 | 2010-06-14 |
| 1740275833 | Byron A Teska | Ophthalmology | 3960 Coon Rapids Blvd Nw, Suite 304, Coon Rapids, MN 55433-2569 | 2005-09-14 |
| 1083617849 | James Adair Cameron | Ophthalmology | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433 | 2005-05-24 |
| 1669475414 | Alfred Oscar Steldt | Ophthalmology | 3790 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2629 | 2005-05-24 |
| 1598121808 | Scott Peterson | Ophthalmology | 3777 Coon Rapids Blvd Nw Ste 100, Coon Rapids, MN 55433-2630 | 2016-01-04 |
| 1912151929 | David V Folden | Ophthalmology | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433 | 2008-11-05 |
| 1689870156 | North Suburban Eye Specialists, LLP | Ophthalmology | 3790 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2629 | 2007-06-22 |
| 1710190939 | Patrick Kelly Johnson | Ophthalmology | 3790 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2629 | 2007-05-07 |
| 1205870045 | Mark Lobanoff | Ophthalmology | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194290486 | Eye Care Associates, Pa | Ophthalmology | 710 E 24th St Ste 101-201, Minneapolis, MN 55404-3840 | 2018-10-12 |
| 1548794316 | Trevor Kindle | Ophthalmology | 200 1st Ave Nw, Rochester, MN 55901 | 2017-04-18 |
| 1790228294 | Eye Associates of Central Minnesota Pa | Ophthalmology | 628 Roosevelt Rd, Suite 101, Saint Cloud, MN 56301-4867 | 2016-12-01 |
| 1093160491 | Christina Gillmor | Ophthalmology | 516 Delaware St Se Fl 9, Minneapolis, MN 55455-0356 | 2016-05-04 |
| 1861889776 | Michael Andrew Jordan | Ophthalmology | 825 Nicollet Mall Ste 2000, Minneapolis, MN 55402-2708 | 2015-04-17 |
| 1467872390 | Luke Dolezal | Ophthalmology | 5851 Duluth St Ste 215, Golden Valley, MN 55422-3956 | 2014-04-17 |
| 1811330939 | James Layer | Ophthalmology | 3708 Upton Ave S, Minneapolis, MN 55410-1237 | 2013-04-08 |
| 1093058158 | Hao Tang | Ophthalmology | 7760 France Ave S Ste 310, Edina, MN 55435 | 2013-03-27 |
| 1407112881 | Phillip Michael Armand Radke | Ophthalmology | 7450 France Ave S Ste 100, Edina, MN 55435-4799 | 2012-04-10 |
| 1023374964 | Sasha Strul | Ophthalmology | 701 25th Ave S Ste 300, Minneapolis, MN 55454-1443 | 2012-04-04 |
| Find all providers with the same taxonomy | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
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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.