JANE POLLOCK JOHNSON – Marriage & Family Therapist, NPI 1093854945

JANE POLLOCK JOHNSON is a healthcare provider. based in Zimmerman, Minnesota. specializing in MARRIAGE AND FAMILY THERAPIST. They hold a License No. 3386 (MN). The NPI Number for JANE POLLOCK JOHNSON is 1093854945

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
JANE POLLOCK JOHNSON
NPI
1093854945
Phone
Not provided
Address
13403 283RD AVE
Enumeration Date
6 February 2007
Last Update Date
11 September 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7637469492
Graduation Year
2014 (12 years ago)
PAC ID
6002266681
Group Practice PAC ID
6406752492
Professional Enrollment ID
I20231221003567
Address ID
MN553300168OT9245XNEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

981 MARRIAGE AND FAMILY THERAPIST in MN

Provider Addresses for JANE POLLOCK JOHNSON

  • 13403 283RD AVE

    ZIMMERMAN, MN 553989217

    Phone:

    Type: Mailing

  • 9245 QUANTRELLE AVE NE

    OTSEGO, MN 553300168

    Phone: (763) 746-9492

    Fax: (763) 746-3685

    Type: Location

  • 911 Northland Dr

    Princeton, MN 553712172

    Phone: (763) 389-1313

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-12-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231221003567IMarriage And Family TherapistMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55398)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406752492View full group profile
NameSpecialtyState
-GA
Clinical PsychologistMN
Mental Health CounselorMN
Clinical Social WorkerMN
Mental Health CounselorMN
Marriage And Family TherapistMN
Mental Health CounselorMN
Mental Health CounselorMN
Clinical Social WorkerMN
Clinical PsychologistMN

Reviews

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Frequently asked questions

How do payers reference JANE POLLOCK JOHNSON?
For JANE POLLOCK JOHNSON, use NPI 1093854945 as the unique 10-digit identifier.
Active or inactive — what applies to JANE POLLOCK JOHNSON?
You should see JANE POLLOCK JOHNSON as active in CMS-hosted NPPES data.
What clinical focus is listed for JANE POLLOCK JOHNSON?
At a glance, JANE POLLOCK JOHNSON is tied to Marriage & Family Therapist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for JANE POLLOCK JOHNSON?
Travel planning: use Zimmerman, Minnesota as the reference point for JANE POLLOCK JOHNSON, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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