Active NPI
Kelly Johnson
- Nurse Practitioner
- Longview, WA
National Provider Identifier
1013254259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP70027451
- Practice address
- 1230 7TH Ave
Longview, WA 98632-3198 - Phone
- (800) 813-2000
- NPI assigned
- Jan 8, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP70027451 | WA | Primary |
Addresses
Primary practice location
1230 7TH Ave
Longview, WA 98632-3198
Mailing address
500 NE Multnomah St Ste 100
Portland, OR 97232-2099
Phone (800) 813-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041308882 | IL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781049600000",
"number": "1013254259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 NE MULTNOMAH ST STE 100",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322099",
"telephone_number": "800-813-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 7TH AVE",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986323198",
"telephone_number": "800-813-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-08",
"last_updated": "2026-06-10",
"certification_date": "2026-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP70027451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; 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.