GORDON DEAN JOHNSON (NPI# 1053588004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053588004 |
| Entity Type | Individual |
| Full Name | GORDON DEAN JOHNSON |
| Practice Address |
27885 170th Ave Sw Crookston MN 56716-9444 |
| Practice Telephone | 2182813506 |
| Practice Fax Number | 2182813015 |
| Mailing Telephone | 2182813506 |
| Mailing Fax Number | 2182813015 |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2008-05-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295841369 | Gordon Stanley Johnson | Optometrist | 2827 Woodruff Rd, Simpsonville, SC 29681-4807 | 2006-08-22 |
| 1205893781 | Gordon Ray Johnson | Otolaryngology | 3906 Lillie Ave., Suite 1, Davenport, IA 52806-4432 | 2006-04-27 |
| 1528406444 | Gordon Mack Johnson | Nurse Anesthetist, Certified Registered | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2013-06-13 |
| 1730444084 | Gordon Johnson | Counselor | 119 W Depot St, Mocksville, NC 27028-2327 | 2012-07-11 |
| 1235201351 | Gordon Christopher Johnson | Chiropractor | 1535 W Northfield Blvd, Suite 6, Murfreesboro, TN 37129-1427 | 2006-11-14 |
| 1235103276 | Gordon Johnson | Hospitalist | 24988 Se Stark St, Gresham, OR 97030-8324 | 2006-02-15 |
| 1316911670 | Gordon Leslie Johnson | Pathology | 10101 W Forest Hill Blvd, Wellington Regional Medical Center Pathology Dept, Wellington, FL 33414 | 2006-02-14 |
| 1932105061 | Gordon L Johnson | Internal Medicine | 1836 South Ave, La Crosse, WI 54601-5429 | 2005-06-23 |
| Street Address |
27885 170TH AVE SW |
| City | CROOKSTON |
| State | MN |
| Zip Code | 56716-9444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588720395 | Independence Plus Incorporate | Home Health | 27885 170th Ave Sw, Crookston, MN 56716-9447 | 2006-12-28 |
| 1164671335 | Amanda Marie Munter | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-09-12 |
| 1528225265 | Beth Hariette Burnette | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-05-20 |
| 1437316171 | Brandon Craig Braun | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-05-20 |
| 1235306291 | Mary Lou Carlson | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-05-09 |
| 1285801225 | Leann Sargent | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-05-09 |
| 1063689008 | Marlene Marie Mcpherson | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-05-09 |
| 1881861821 | Rosa Maria Martinez | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-05-09 |
| 1598932543 | Sheila Dawn Jerik | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-05-09 |
| 1518134550 | Betty Jean Olson | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942789912 | Savannah Danielle Miller | Pharmacist | 323 S Minnesota Street, Crookston, MN 56716 | 2018-08-10 |
| 1902037377 | David Fernando Frugone Larrea | Internal Medicine | 400 South Minnesota Street, Crookston, MN 56716 | 2009-08-04 |
| 1831327964 | Andres O Makarem | Internal Medicine | 400 S. Minnesota Ave, Crookston, MN 56716 | 2009-06-26 |
| 1255498564 | Ind School District 593 | Local Education Agency (LEA) | 402 Fisher Ave, Crookston, MN 56716 | 2007-01-03 |
| 1821109422 | Marla Rae Love | Dietitian, Registered | 400 S Minnesota Street, Crookston, MN 56716 | 2006-08-31 |
| 1508835133 | Northwestern Mental Health Center | Clinic/Center | 603 Bruce St, Crookston, MN 56716 | 2006-03-16 |
| 1215932728 | Villa St. Vincent | Skilled Nursing Facility | 516 Walsh St, Crookston, MN 56716 | 2005-06-21 |
| 1740769090 | Christine Jane Loff | Physical Therapist | 323 S Minnesota St, Crookston, MN 56716 | 2018-08-08 |
| 1821533035 | Lauren Shalane Wagendorf | Counselor | 603 Bruce St, Crookston, MN 56716 | 2016-12-23 |
| 1336594449 | Lesmeister Dental LLC | Dentist | 1726 University Ave, Crookston, MN 56716 | 2016-04-26 |
| Find all providers in zip 56716 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164671335 | Amanda Marie Munter | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-09-12 |
| 1528225265 | Beth Hariette Burnette | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-05-20 |
| 1437316171 | Brandon Craig Braun | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-05-20 |
| 1235306291 | Mary Lou Carlson | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-05-09 |
| 1285801225 | Leann Sargent | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-05-09 |
| 1063689008 | Marlene Marie Mcpherson | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-05-09 |
| 1881861821 | Rosa Maria Martinez | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-05-09 |
| 1598932543 | Sheila Dawn Jerik | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-05-09 |
| 1518134550 | Betty Jean Olson | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-05-09 |
| 1235306275 | Shirley Anne Waechter | Technician | 27885 170th Ave Sw, Crookston, MN 56716-9444 | 2008-05-09 |
| Find all providers in CROOKSTON | ||||
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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.