Kevin Darnell Johnson, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

125065696 Issued in IL

Practice address

5101 Willow Springs Rd
2ND Floor
La Grange, IL 60525-2600

Phone

(708) 245-8900

Fax

(708) 245-5604

NPI assigned

Jun 23, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1003221680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 WILLOW SPRINGS RD",
            "address_2": "2ND FLOOR",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605252600",
            "telephone_number": "708-245-8900",
            "fax_number": "708-245-5604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 WILLOW SPRINGS RD",
            "address_2": "2ND FLOOR",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605252600",
            "telephone_number": "708-245-8900",
            "fax_number": "708-245-5604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KEVIN",
        "middle_name": "DARNELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125065696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joey Harman, LCPC, NCC
• John E. Anderson O.D.,LTD
• Kerry M John, OD
• Megan M John, LCPC
• Gerald Timothy Johnson, M.D.
• Carly Jones, PT, OCS, CMT, ATC
• Lavon Jones, OTR/L
• Sarah Jones
• Taylor Jones, BCBA
• Jr Counseling Services Inc

• Student in an Organized Health Care Education/Training Program in La Grange, IL
• Providers in La Grange, IL by specialty
• Student in an Organized Health Care Education/Training Program in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.