Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Chandler Johnson

Individual provider Occupational Therapist · NPI 1801601620

Chandler Johnson is an Occupational Therapist in Private Practice in Eden Prairie, Minnesota. Qualified in 2024, 2 years ago. Practices with Odom Sports Medicine PA, a 69-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
2
Licensed in
MN
In the registry since
2025
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Practice location Address checks out

6545 Flying Cloud Dr Ste 201
Eden Prairie, MN 55344-3356
Phone: (612) 364-1901
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 107698 (MN)

Record details

NPI number1801601620
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 10, 2025
Last updated in NPPESMarch 18, 2025
Certification dateMarch 18, 2025
Mailing address6545 Flying Cloud Dr Ste 201, Eden Prairie, MN 55344-3356

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Odom Sports Medicine Pa — 69 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Eden Prairie