WADE JOHNSON (NPI# 1235530890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235530890 |
| Entity Type | Individual |
| Full Name | WADE JOHNSON |
| Credential | DO |
| Practice Address |
1025 Marsh St Mankato MN 56001-4752 |
| Mailing Address |
200 1st St Sw Rochester MN 55905-0001 |
| Practice Telephone | 5076254031 |
| Enumeration Date | 2014-09-14 |
| Last Update Date | 2020-10-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
63980 | MN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 Woods Rd, Valhalla, NY 10595 | 9144937000 | |
| 200 1st St Sw, Rochester, MN 559050001 | 5072842511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801142971 | Wade Lane Johnson | Psychiatry & Neurology | 104 Moodys Run, Williamsburg, VA 23185-6557 | 2012-07-26 |
| 1326668641 | Wade Aaron Johnson | Pharmacist | 551 S Illinois Ave, Mason City, IA 50401-4441 | 2020-04-17 |
| Street Address |
1025 MARSH ST |
| City | MANKATO |
| State | MN |
| Zip Code | 56001-4752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154316206 | James J Milavetz | Internal Medicine | 1025 Marsh St, Mankato, MN 56001-4752 | 2005-09-14 |
| 1811596059 | Kiman Dinh | Pharmacist | 1025 Marsh St, Mankato, MN 56001-4752 | 2020-10-20 |
| 1295349710 | Joseph Flynn | Pharmacist | 1025 Marsh St, Mankato, MN 56001-4752 | 2020-09-02 |
| 1972115962 | Mohamed A Ibrahim | Community Health Worker | 1025 Marsh St, Mankato, MN 56001-4752 | 2020-08-20 |
| 1174147110 | Emily Behrend | Advanced Practice Midwife | 1025 Marsh St, Mankato, MN 56001-4752 | 2020-06-05 |
| 1205455755 | Whitney Farr | Social Worker | 1025 Marsh St, Mankato, MN 56001-4752 | 2020-04-15 |
| 1134765233 | Kay S Williams | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-11-23 |
| 1871138263 | Sydney Mcinnis | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-11-09 |
| 1730739061 | Kelsey Elizabeth Mork | Physician Assistant | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-09-18 |
| 1891345369 | Matthew Joseph Perri | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| Taxonomy Code | 2081S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Sports Medicine |
| A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. |
| Notes: Source: American Board of Medical Specialties, 2009. www.abms.org [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902310154 | Dorothy Jane Hanna | Physical Medicine & Rehabilitation | 10939 Quebec Ave N, Champlin, MN 55316-3261 | 2017-11-27 |
| 1932502267 | Kyle Braulick | Physical Medicine & Rehabilitation | 5025 Edinburgh Way, Big Lake, MN 55309-8271 | 2014-10-01 |
| 1790020949 | Shelby N Kenison | Physical Medicine & Rehabilitation | 28675 740th Ave, Clarks Grove, MN 56016-4041 | 2012-11-29 |
| 1770806374 | Kevin Neil Johnson | Physical Medicine & Rehabilitation | 9913 214th St W Ste B, Lakeville, MN 55044-1914 | 2010-03-10 |
| 1962069864 | Allyson Carol Maynard | Physical Medicine & Rehabilitation | 800 Prairie Center Dr Ste 230, Eden Prairie, MN 55344-7308 | 2019-05-26 |
| 1831672492 | Nathaniel Erik Thomsen | Physical Medicine & Rehabilitation | 300 S Bruce St, Marshall, MN 56258-1934 | 2018-09-10 |
| 1023517364 | Hannah Rhiannon Salisbury | Physical Medicine & Rehabilitation | 3900 Bethel Dr, Arden Hills, MN 55112-6902 | 2018-02-01 |
| 1386006682 | Allison Nicole Schroeder | Physical Medicine & Rehabilitation | 200 1st St Sw, Rochester, MN 55905-0001 | 2016-03-25 |
| 1063758290 | Katherine N Nanos | Physical Medicine & Rehabilitation | 200 1st St Sw, Rochester, MN 55905-0001 | 2012-12-16 |
| 1194070409 | Jenna Marie Swenson | Physical Medicine & Rehabilitation | 1625 Radio Dr Ste 220, Woodbury, MN 55125 | 2012-07-24 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on WADE JOHNSON.
| 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.