DR. NICOLE MARIE JOHNSON
NPI 1750868212
Psychologist - Clinical in Burnsville, MN

Q: What is Nicole Johnson's NPI number?

The NPI number for Nicole Johnson is 1750868212. It was assigned to this individual provider in the NPPES registry on July 26, 2018.

Q: What is Nicole Johnson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Nicole Johnson enrolled in Medicare?

No. Nicole Johnson has opted out of Medicare through December 8, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Nicole Johnson was last updated on September 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.

Active since July 26, 2018Opted out of Medicare · through Dec 8, 2027

200 E TRAVELERS TRL STE 205, BURNSVILLE, MN 55337(612) 249-0269 Get Directions Write a Review

NPPES record last updated: September 11, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2020, Oct 7, 2019, Jul 26, 2018 (3 updates tracked since 2018).

On this page

About Dr. Nicole Marie Johnson NPPES

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

DR. NICOLE MARIE JOHNSON (NPI 1750868212) is an individual clinical provider in Burnsville, Minnesota, licensed in Minnesota (LP6452) and active in the NPI registry since July 2018. She has opted out of Medicare through December 8, 2027 and maintains a secondary practice location in Eagan.

NPPES Registry Identity

NPI1750868212

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. NICOLE MARIE JOHNSON

Location Address200 E TRAVELERS TRL STE 205Burnsville, MN 55337-4191

Mailing Address200 E Travelers Trl Ste 205Burnsville, MN 55337-4191 · (612) 249-0269

Phone(612) 249-0269

Sole ProprietorNo

Enumeration DateJuly 26, 2018

Last NPPES UpdateSeptember 11, 20203 updates tracked since enumeration

NPPES CertifiedSeptember 11, 2020

✔ NPI 1750868212 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in MN · LP6452

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

200 E TRAVELERS TRL STE 205, Burnsville, MN 55337

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Secondary Practice Location 1

Location 14660 Slater Rd Ste 210Eagan, MN 55122 · Phone (612) 540-5108

Other Identifiers 1

Other1750868212MN · Npi I

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Nicole Marie Johnson has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 8, 2023 through December 8, 2027.

Opt-Out Effective DateDecember 8, 2023

Opt-Out In Effect ThroughDecember 8, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 2

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

STRATA PSYCHIATRY PLLC

Nurse Practitioner (Psychiatric/Mental Health)

200 E TRAVELERS TRL STE 205
BURNSVILLE, MN 55337

Dakota County (612) 254-9782

NICOLE M. JOHNSON, PSYD, LP, LLC

Psychologist (Clinical)

200 E TRAVELERS TRL STE 205
BURNSVILLE, MN 55337

Dakota County (612) 249-0269

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 Nicole Johnson's NPI number?

The NPI number for Nicole Johnson is 1750868212. It was assigned to this individual provider in the NPPES registry on July 26, 2018.

Where is Nicole Johnson located?

Nicole Johnson practices at 200 E Travelers Trl Ste 205, Burnsville, MN 55337. The listed phone number is (612) 249-0269.

What is Nicole Johnson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Nicole Johnson enrolled in Medicare?

No. Nicole Johnson has opted out of Medicare through December 8, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Nicole Johnson accept?

Health plans from HealthPartners list Nicole 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 Nicole Johnson was last updated on September 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.