Individual provider Active NPI

Kimberly Lawayne Johnson, RN

  • Family Nurse Practitioner
  • Centreville, AL
National Provider Identifier
1053173393
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-189125 Issued in AL
Practice address
405 Belcher St
Centreville, AL 35042-2946
Phone
(205) 926-2992
NPI assigned
Jan 23, 2024
Last updated
Sep 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-189125 AL Primary

Addresses

Primary practice location

405 Belcher St
Centreville, AL 35042-2946

Mailing address

405 Belcher St
Centreville, AL 35042-2946
Phone (205) 926-2992

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20251030004549 AL Practitioner - Nurse Practitioner 2961991716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cahaba Medical Care FoundationGroup PAC ID 1355597923, 100 clinicians

Practice addresses (Care Compare)

195 Hospital Dr
Centreville, AL 35042-2935
Phone (205) 926-2992

405 Belcher St
Centreville, AL 35042-2946
Phone (205) 926-2992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-189125ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cahaba Medical Care Foundation CurrentSince Oct 21, 2025 Accepting new patients
Cahaba Medical Care Foundation CurrentSince Oct 21, 2025 Accepting new patients

Locations

195 Hospital Dr
Centreville, AL 35042
Phone (205) 225-7455

405 Belcher St
Centreville, AL 35042
Phone (205) 926-4694

Interoperability endpoints

  • Direct secure messaging: kimberly.johnson.1@11347.direct.athenahealth.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1053173393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 BELCHER ST",
            "city": "CENTREVILLE",
            "state": "AL",
            "postal_code": "350422946",
            "telephone_number": "205-926-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 BELCHER ST",
            "city": "CENTREVILLE",
            "state": "AL",
            "postal_code": "350422946",
            "telephone_number": "205-926-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIMBERLY",
        "middle_name": "LAWAYNE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-189125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, AL

Sources for this page

Verify at the official NPI Registry.