Kyle Robert Johnson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

16983A Issued in WY

Practice address

111 S 5TH St
Douglas, WY 82633-2434

Phone

(307) 358-2122

NPI assigned

Mar 21, 2019

Sex

Male

Sole proprietor

Yes

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

Enrolled in WY

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

Specialty

Emergency Medicine

Education

Oregon Health & Sciences Univ School of Dentistry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Hospital of Converse County 77 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital of Converse County Hospital, Douglas, WY, CCN 531302

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.

• Memorial Hospital of Converse County

  • Critical Access Hospital
  • Douglas, WY
  • NPI 1326085408

  WY

  Medicare reassignment Care Compare group NPD
• Memorial Hospital of Converse County

  • General Practice Physician
  • Douglas, WY
  • NPI 1356496491

  WY

  Medicare reassignment Care Compare group NPD
• North Lincoln County Hospital District

  • Critical Access Hospital
  • Afton, WY
  • NPI 1255376406

  WY

  Medicare reassignment NPD
• North Lincoln County Hospital District

  • Family Medicine Physician
  • Afton, WY
  • NPI 1730132523

  WY

  Medicare reassignment NPD
• Memorial Hospital of Converse County

  • Medicare Defined Swing Bed Hospital Unit
  • Douglas, WY
  • NPI 1285643221
  Care Compare group
• Memorial Hospital of Converse County

  • Rural Health Clinic/Center
  • Glenrock, WY
  • NPI 1679582357
  Care Compare group
• Memorial Hospital of Converse County

  • Rural Health Clinic/Center
  • Guernsey, WY
  • NPI 1871503375
  Care Compare group

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

• Memorial Hospital of Converse County

  • Critical Access Hospital
  • Douglas, WY
  • NPI 1326085408

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1063972487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 5TH ST",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826332434",
            "telephone_number": "307-358-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 5TH ST",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826332434",
            "telephone_number": "307-358-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KYLE",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WY",
            "license": "16983A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jciloa
• Katie Jenkins
• Deeanne Joy Johnson-Engle, M.D.
• Jessica Paige Johnson, SLP/A
• Julie Lynn Johnson, APRN
• Linda Kay Johnson, M.A.
• Rachel D Jones
• Gretchen Kassner, BS
• Alexandra Nicole Keeler, DDS
• Robert D Keeler, D.C.

• All providers in Douglas, WY
• Emergency Medicine Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.