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KELLY JOHNSON
NPI 1184294670
Social Worker - Clinical in Fargo, ND

Active since June 28, 2021PECOS EnrolledAccepts Medicare Assignment
1635 43RD ST S STE 105, FARGO, ND 58103(701) 412-2973 Get Directions Write a Review

NPPES record last updated: October 15, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 19, 2022, Jul 8, 2022, Jun 28, 2021 (3 updates tracked since 2021).

About Kelly Johnson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY JOHNSON (NPI 1184294670) is an individual clinical provider in Fargo, North Dakota, licensed in North Dakota (6079) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1184294670
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKELLY JOHNSON
Location Address1635 43RD ST S STE 105Fargo, ND 58103-3579
Mailing Address1547 30th Ave SMoorhead, MN 56560-5149 · (218) 287-4338
Phone(701) 412-2973
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateJune 28, 2021
Last NPPES UpdateOctober 15, 20253 updates tracked since enumeration
NPPES CertifiedOctober 15, 2025
✔ NPI 1184294670 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in ND · 6079
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1635 43RD ST S STE 105, Fargo, ND 58103
Open in Google Maps ↗

Other Names 1

Former Name (1)Kelly Ross

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Johnson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4880076785
PECOS Enrollment IDI20220808003511
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kelly Johnson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Solutions Behavioral Healthcare Professionals, PC
4.8 mi
Mental Health (Including Community Mental Health Center)
1547 30TH AVE S
Moorhead, MN 56560
  • Reassigned Medicare billing, North Dakota enrollment
  • 20 clinicians in this Medicare group
NPI 1801909239 (218) 287-4338

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 58103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $55.75 – $168.12
Typical copayment $0.00 (range $13.93 – $42.03)
Most-billed visit code NA
Established Patient
$69.48 typical visit price
range $18.11 – $137.65
Typical copayment $17.37 (range $4.52 – $34.41)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANI CELINE MANGOLD PHD, LP
Psychologist (Clinical)
1635 43RD ST S STE 105
FARGO, ND 58103
Cass County (218) 287-4338
GARRICK LEITH
Behavior Analyst
1635 43RD ST S STE 105
FARGO, ND 58103
Cass County (701) 412-2973
JOLYNN LENTZ
Behavior Analyst
1635 43RD ST S STE 105
FARGO, ND 58103
Cass County (701) 412-2973
KATHARINE BARRETT FERGUSON LMSW
Social Worker (Clinical)
1635 43RD ST S STE 105
FARGO, ND 58103
Cass County (218) 287-4338
MARY KATHARINE EPPING LAC, LCSW
Social Worker (Clinical)
1635 43RD ST S STE 105
FARGO, ND 58103
Cass County (218) 287-4338
KELSEY MEHUS
Social Worker (Clinical)
1635 43RD ST S STE 105
FARGO, ND 58103
Cass County (701) 412-2973
MISTY WRIGHT
Counselor (Professional)
1635 43RD ST S STE 105
FARGO, ND 58103
Cass County (701) 412-2973
REBECCA MARTIN
Counselor (Professional)
1635 43RD ST S STE 105
FARGO, ND 58103
Cass County (218) 287-4338

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Johnson's NPI number?

The NPI number for Kelly Johnson is 1184294670. It was assigned to this individual provider in the NPPES registry on June 28, 2021. The provider is also known as Kelly Ross.

Where is Kelly Johnson located?

Kelly Johnson practices at 1635 43rd St S Ste 105, Fargo, ND 58103. The listed phone number is (701) 412-2973.

What is Kelly Johnson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kelly Johnson enrolled in Medicare?

Yes. Kelly Johnson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kelly Johnson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Johnson reassigns Medicare benefits to Solutions Behavioral Healthcare Professionals, PC (Moorhead, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelly Johnson accept?

Health plans from Blue Cross Blue Shield of North Dakota and Sanford Health Plan list Kelly Johnson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelly Johnson was last updated on October 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.