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

Jeremiah Johnson, A-GNP

Individual provider Nurse Practitioner · NPI 1710548862

Jeremiah Johnson, A-GNP is a Nurse Practitioner in Fargo, North Dakota. Qualified in 2019, 7 years ago. Practices with Sanford Medical Center Fargo, a 1,212-clinician group, accepts Medicare assignment and offers telehealth. Licensed in North Dakota.

Years since qualifying
7
Licensed in
ND
In the registry since
2019
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Practice location Address checks out

736 Broadway N
Fargo, ND 58102-4421
Phone: (701) 234-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence R39076 (ND)

Record details

NPI number1710548862
Entity typeIndividual (Type 1)
GenderMale
Credentials A-GNP
Sole proprietorNo
NPI enumeratedJune 27, 2019
Last updated in NPPESSeptember 3, 2024
Certification dateSeptember 3, 2024
Mailing addressPo Box 5074, Sioux Falls, SD 57117-5074

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Sanford Medical Center Fargo — 1212 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Fargo