Kenneth R Johnson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

AZ08759 Issued in AZ

Practice address

630 N Alvernon Way Ste 180
Tucson, AZ 85711-1895

Phone

(520) 322-8450

Fax

(520) 322-5446

NPI assigned

Dec 12, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053472332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 N ALVERNON WAY STE 180",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111895",
            "telephone_number": "520-322-8450",
            "fax_number": "520-322-5446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N ALVERNON WAY STE 180",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111895",
            "telephone_number": "520-322-8450",
            "fax_number": "520-322-5446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KENNETH",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "AZ08759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith M Johnson, D.C.
• Kai C Johnson, PA-C
• Karen H Johnson
• Katelyn Grace Johnson, LCSW
• Kathryn Johnson, L.L.P.C.
• Kerry Daetwyler Johnson, RN
• Kiara Johnson, RRT
• Kristen Johnson, PT
• Kristine Arrieta Johnson, PA
• Lane Johnson, MD

• Surgery Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.