Walter S Johnson (NPI# 1124043468, PAC ID# 4981793577) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1124043468 |
| PAC ID by PECOS | 4981793577 |
| Professional Enrollment ID | I20071205000010 |
| Full Name | Walter S Johnson |
| Organization Legal Name | INNOVIS HEALTH, LLC |
| Address |
1702 University Dr S Fargo ND 58103-4940 |
| Phone Number | 7013643300 |
| Gender | M |
| Medical School | UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE |
| Graduation Year | 1978 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 9931298155 |
| Number of Group Practice Members | 371 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 350070 | ESSENTIA HEALTH |
| 240101 | ESSENTIA HEALTH ST MARYS - DETROIT LAKES |
| Address | Phone | Organization |
|---|---|---|
| 1702 University Dr S, Fargo, ND 58103-4940 | 7013643300 | INNOVIS HEALTH, LLC |
| 3000 32nd Ave S, Fargo, ND 58103-6132 | 7013648000 | INNOVIS HEALTH, LLC |
| Organization Legal Name | INNOVIS HEALTH, LLC |
| Physicians | 358 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kyrie Marie Severson | Nurse Practitioner | Innovis Health, LLC | 4622 40th Ave S, Suite A, Fargo, ND 58104-4394 |
| Holli Marquart | Nurse Practitioner | Innovis Health, LLC | 2430 20th St Sw, Jamestown, ND 58401-6201 |
| Michelle R Bradley | Family Medicine | Innovis Health, LLC | 4110 51st Ave S, Fargo, ND 58104-7776 |
| Taylor G Mertz | Family Medicine | Innovis Health, LLC | 801 Belsly Blvd, Moorhead, MN 56560-5055 |
| Bonita J Jenzen | Nurse Practitioner | Innovis Health, LLC | 501 Main Ave S, Hankinson, ND 58041-4108 |
| Zena K Homan | Obstetrics/gynecology | Innovis Health, LLC | 3000 32nd Ave S, Fargo, ND 58103-6132 |
| Daniel J Levin | Optometry | Innovis Health, LLC | 1100 19th Ave N, Suite Landm, Fargo, ND 58102-5906 |
| Brian K Cooper | Physician Assistant | Innovis Health, LLC | 275 11th St S, Wahpeton, ND 58075-4655 |
| Joel Ross Haugen | Family Medicine | Innovis Health, LLC | 5 9th Ave N, Casselton, ND 58012-3339 |
| Hans E Bjellum | Family Medicine | Innovis Health, LLC | 720 Main Ave, Moorhead, MN 56560-2752 |
| Street Address |
1702 UNIVERSITY DR S |
| City | FARGO |
| State | ND |
| Zip | 58103-4940 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bangalore S Vijayalakshmi | Physical Medicine and Rehabilitation | Innovis Health, LLC | 1702 University Dr S, Fargo, ND 58103-4940 |
| Kayla M Flach | Qualified Speech Language Pathologist | Innovis Health, LLC | 1702 University Dr S, Fargo, ND 58103-4940 |
| Robert Alan Renschler | Podiatry | Innovis Health, LLC | 1702 University Dr S, Fargo, ND 58103-4940 |
| Christian J Sorensen | Internal Medicine | Innovis Health, LLC | 1702 University Dr S, Fargo, ND 58103-4940 |
| Gregory A Hauge | Psychologist, Clinical | Innovis Health, LLC | 1702 University Dr S, Fargo, ND 58103-4940 |
| Rachel K Nelles | Nurse Practitioner | Innovis Health, LLC | 1702 University Dr S, Fargo, ND 58103-4940 |
| Josalyn J Grueneich | Nurse Practitioner | Innovis Health, LLC | 1702 University Dr S, Fargo, ND 58103-4940 |
| Joni L Buechler Price | Radiation Oncology | Innovis Health, LLC | 1702 University Dr S, Fargo, ND 58103-4940 |
| Shaun K Christenson | Neurology | Innovis Health, LLC | 1702 University Dr S, Fargo, ND 58103-4940 |
| Lindsey N Nelson | Certified Registered Nurse Anesthetist (crna) | Innovis Health, LLC | 1702 University Dr S, Fargo, ND 58103-4940 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gary E Johnson | Optometry | Mark Tufte Od PC | 1801 45th St S, Suite G, Fargo, ND 58103-0801 |
| Mark G Tufte | Optometry | Mark Tufte Od PC | 1801 45th St S, Suite G, Fargo, ND 58103-0801 |
| Anthony Heath Charbonneau | Physical Therapy | Total Balance Physical Therapy and Fitness LLC | 4041 Main Ave, Fargo, ND 58103-1145 |
| Scott B Phillips | Neurosurgery | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Marcus F Keep | Neurosurgery | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Behzad S Sabit | Neurosurgery | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Abdul A Baker | Neurosurgery | Sanford Clinic North | 700 1st Ave S, Fargo, ND 58103-1802 |
| Michael David Manchak | Neurology | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Tahereh Keshavarz | Physician Assistant | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Tong Yang | Neurosurgery | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Find all physicians in zip 58103 | |||
| City | FARGO |
| Zip Code | 58103 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | FARGO + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Walter S Johnson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.