Jaclyn A. Johnson, RD
NPI 1811488430ActiveIndividual· Dietitian, Registered· Willmar, MN
Dietitian, Registered (RD) in Willmar, Minnesota, trained at University of Minnesota Medical School (class of 2016). Medicare paid $8,035 for services to 93 patients in 2024.
Overview
| NPI | 1811488430 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | RD |
| Sole proprietor | No |
| NPI issued | May 21, 2018 |
| Last updated in NPPES | May 25, 2023 |
| Certified by provider | May 25, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | 3952 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Registered Dietitian Or Nutrition Professional (MN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 93 |
|---|---|
| Services billed | 226 across 3 procedure codes |
| Paid by Medicare | $8,035 |
Education and affiliations
| Medical school | University of Minnesota Medical School |
|---|---|
| Graduation year | 2016 |
| Medicare specialty | Registered Dietitian Or Nutrition Professional |
| Telehealth | Offers telehealth |
Medical group
- Centracare Clinic Southwest LLCWillmar, MN · 170 clinicians
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