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1649281361

NPI Code Detail

MEDICARE: ANDREW J JOHNSON DPM

MEDICARE: ANDREW J JOHNSON DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	801	MN
2	213ES0103X	Foot & Ankle Surgery Podiatrist	801	MN
3	213E00000X	Podiatrist	PO00000770	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	P00235433	OTHER	WA	RAILROAD
3	0207841	OTHER	WA	L & I
4	8905370	OTHER	WA	CRIME VICTIMS
5	0196122	OTHER	WA	L & I
6	8941204	OTHER	WA	CRIME VICTIMS

General Provider Information

NPI Number	:	1649281361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW J JOHNSON DPM

Provider Business Mailing Address
First Line	:	PO BOX 5074
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57117-5074
Country	:	US
Telephone Number	:	605-328-9419
Fax Number	:	605-312-9802

Provider Business Practice Location Address
First Line	:	1245 S WASHINGTON AVE
Second Line	:
City	:	DETROIT LAKES
State	:	MN
Zip	:	56501-3905
Country	:	US
Telephone Number	:	218-846-2000
Fax Number	:	218-846-2114

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	06/05/2026

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Directions to “ ANDREW J JOHNSON DPM” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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