Dr. Tina Marie Johnson, M.D.
Internal Medicine in Woodbury, MN. Individual provider (NPI-1).
NPI number1316004393
StatusActive
Last updated in NPPESJun 17, 2008
Details
- NPI
- 1316004393
- Entity type
- Individual (NPI-1)
- Name
- Dr. Tina Marie Johnson
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 2, 2007
- Last updated
- Jun 17, 2008
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- Medicare opt-out
- Apr 1, 2019 to Apr 1, 2027
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 48536 | MN | Yes |
Practice location
1875 Woodwinds DrWoodbury, MN 55125-2298
Phone 651-232-6700
Mailing address
1875 Woodwinds DrWoodbury, MN 55125-2298
Phone 651-232-6700
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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