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

Keith Johnson, MD

Individual provider Family Medicine Physician · NPI 1013412956

Keith Johnson, MD is a Family Practice in Maple Grove, Minnesota. Graduated from University of Arizona College of Medicine in 2018, 8 years ago. Licensed in Minnesota and North Carolina.

Years since qualifying
8
Trained at
University of Arizona College of Medicine
Licensed in
MN, NC
In the registry since
2018
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

9855 Hospital Dr Ste 102
Maple Grove, MN 55369-4648
Phone: (763) 581-5900
Fax: (763) 581-5901
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 69882 (MN)
Family Medicine Physician Taxonomy 207Q00000X · Licence 238295 (NC)

Record details

NPI number1013412956
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 23, 2018
Last updated in NPPESJuly 29, 2021
Certification dateJuly 29, 2021
Mailing address2001 Vail Ave, Charlotte, NC 28207-1248

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF ARIZONA COLLEGE OF MEDICINE
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Not indicated

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