JACLYN A JOHNSON RD
NPI 1811488430
Dietitian, Registered in Willmar, MN
About Jaclyn A Johnson Rd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACLYN A JOHNSON RD (NPI 1811488430) is an individual dietitian, registered in Willmar, Minnesota, licensed in Minnesota (3952) and active in the NPI registry since May 2018. She is a graduate of University Of Minnesota Medical School (2016).
NPPES Registry Identity
Specialties & Licenses
Accepted 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
Jaclyn A Johnson Rd 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.
Medicare Billing Reassignments
2Medicare enrollment records show Jaclyn Johnson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Willmar, MN 56201
- Reassigned Medicare billing, Minnesota enrollment
- 236 clinicians in this Medicare group
Benson, MN 56215
- Reassigned Medicare billing, Minnesota enrollment
- Also billed through NPI 1023728516 (Minnesota)
- 95 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 56201 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
WILLMAR, MN 56201
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 Jaclyn Johnson's NPI number?
The NPI number for Jaclyn Johnson is 1811488430. It was assigned to this individual provider in the NPPES registry on May 21, 2018.
Where is Jaclyn Johnson located?
Jaclyn Johnson practices at 1604 1st St S, Willmar, MN 56201. The listed phone number is (320) 231-6348.
What is Jaclyn Johnson's specialty?
The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.
Is Jaclyn Johnson enrolled in Medicare?
Yes. Jaclyn 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 organizations bill Medicare for Jaclyn Johnson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jaclyn Johnson reassigns Medicare benefits to 2 organizations: Centracare Clinic Southwest LLC (Willmar, MN) and Centracare Health - Benson LLC (Benson, MN). Each 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 Jaclyn Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jaclyn Johnson accept?
Health plans from Sanford Health Plan list Jaclyn 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 Jaclyn Johnson was last updated on May 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Jaclyn A Johnson, RD · NPI 1811488430
Dietitian, Registered provider in Willmar, Minnesota. Individual provider, active in the CMS NPPES registry since May 21, 2018.
## Identity
- **NPI:** 1811488430 (Entity type: Individual)
- **Enumerated:** May 21, 2018
- **Primary specialty:** Dietitian, Registered · taxonomy 133V00000X
- **State license:** 3952 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 1604 1ST ST S, Willmar, MN 56201-4243
- **Phone:** (320) 231-6348 · **Fax:** (320) 231-5067
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Centracare Clinic Southwest LLC (NPI 1174106264, Willmar, MN); Centracare Health - Benson LLC (NPI 1326757154, Benson, MN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Minnesota Medical School, class of 2016
## Record status
- **NPPES last updated:** May 25, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1811488430) · Data from the CMS NPPES public registry.