Kenneth S Johnson, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A43322 Issued in CA

Practice address

18685 Main St # a
Suite 600
Huntington Beach, CA 92648-1723

Phone

(562) 407-2080

NPI assigned

Oct 18, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• KND Development 59 LLC

  • Hospitalist Physician
  • Santa Ana, CA
  • NPI 1740519081
  Medicare reassignment NPD
• Kenneth Johnson, MD, Apc

  • Anesthesiology Physician
  • Santa Ana, CA
  • NPI 1073722534
  NPD (past) Authorized official
• Personal Care Hospice Services, Inc

  • Community Based Hospice Care Agency
  • Burbank, CA
  • NPI 1730408568
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1023199882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4259",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907034259",
            "telephone_number": "562-407-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18685 MAIN ST # A",
            "address_2": "SUITE 600",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481723",
            "telephone_number": "562-407-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KENNETH",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A43322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A433223",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daelyn Renee Johnson
• Damiyah Johnson
• Gregory L Johnson, DDS
• Isrialle Johnson
• Jayla Johnson
• Lauren Johnson, SLP
• Marissa Iona Johnson
• Mary Alison Johnson, R1462450322
• Megan Johnson
• Michelle Johnson, LMFT

• Anesthesiology Physician in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.