Kimberly McBride Johnson, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

2012030845 Issued in MO

Practice address

One Hospital Drive
Columbia, MO 65212-0001

Phone

(573) 882-4909

Fax

(573) 884-5184

NPI assigned

Aug 20, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jordan Physician Associates IncGroup PAC ID 1254321086, 166 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kjohnson252674@direct.bilh.masshiway.net

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.

• Jordan Physician Associates, Inc.

  • Family Medicine Physician
  • Plymouth, MA
  • NPI 1538145131
  Medicare reassignment Care Compare group NPD
• Coastal Medical Associates

  • Anesthesiology Physician
  • Weymouth, MA
  • NPI 1932175684
  Medicare reassignment
• Jordan Physician Associates, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Plymouth, MA
  • NPI 1194263186
  NPD
• Steward Medical Group, Inc

  • Specialist
  • Watertown, MA
  • NPI 1629398219
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Beth Israel Deaconess Hospital Plymouth, Inc.

  • General Acute Care Hospital
  • Plymouth, MA
  • NPI 1043299001
  Care Compare affiliation

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

{
    "created_epoch": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369785600000",
    "number": "1033467287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7687",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652057687",
            "telephone_number": "573-882-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE HOSPITAL DRIVE",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652120001",
            "telephone_number": "573-882-4909",
            "fax_number": "573-884-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIMBERLY",
        "middle_name": "MCBRIDE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-20",
        "last_updated": "2013-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "2012030845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harold Albert Johnson, MD
• Hayden Otto Johnson
• Jeremy C Johnson, D.O.
• John Anthony Johnson, DDS
• Karen P Johnson, CRNA
• Kirsten Angela Johnson, RDH
• Kody R Johnson, D.C.
• Kristen Laprade Johnson, PHD
• Linda Pogorzelski Johnson, LPC, M.ED.
• Mary I Johnson, APRN

• Surgical Physician Assistant in Columbia, MO
• Providers in Columbia, MO by specialty
• Surgical Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.