NPIMap

Individual provider Active NPI

Katherine Mirro Johnson, D.O.

  • Infectious Disease Physician
  • Wheat Ridge, CO
National Provider Identifier
1083888937
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
53932 Issued in CO
Practice address
3885 Upham St
Suite 200
Wheat Ridge, CO 80033-4880
Phone
(303) 425-9245
Fax
(303) 425-1378
NPI assigned
Apr 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Infectious Disease Physician 207RI0200X 53932 CO Primary

Addresses

Primary practice location

3885 Upham St
Suite 200
Wheat Ridge, CO 80033-4880

Mailing address

PO Box 1449
Wheat Ridge, CO 80034-1449
Phone (303) 425-9245

Other names 1

  • Miss Katherine Marie Mirro Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kjohnson@widc.careclouddirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140718002049 CO Practitioner - Infectious Disease 8426274986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Western Infectious Disease Consultants, P.C.Group PAC ID 6305736786, 13 clinicians

Practice addresses (Care Compare)

3885 Upham St
Suite 200
Wheat Ridge, CO 80033-4800
Phone (303) 425-9245

Hospital & facility affiliations

  • Centura Health-St Anthony Hospital Hospital, Lakewood, CO, CCN 060015
  • Intermountain Health Lutheran Hospital Hospital, Wheat Ridge, CO, CCN 060009
  • HCA Healthone Mountain Ridge Hospital, Thornton, CO, CCN 060065
  • Orthocolorado Hosp at St Anthony Med Campus Hospital, Lakewood, CO, CCN 060124
  • Intermountain Health Platte Valley Hospital Hospital, Brighton, CO, CCN 060004

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue132
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
53932COMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Infectious Disease Consultants, P.C. Infectious Disease CurrentSince Jul 28, 2014 Accepting new patients
Western Infectious Disease Consultants, P.C. Infectious Disease CurrentSince Jul 28, 2014 Accepting new patients

Locations

3303 W 144th Ave
Unit 103
Broomfield, CO 80023
Phone (303) 425-9245

1536 Cole Blvd
Ste 120
Lakewood, CO 80401
Phone (303) 423-8334

3885 Upham St
Ste 200
Wheat Ridge, CO 80033
Phone (303) 425-9245

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 and National Provider Directory roles.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1083888937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1449",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800341449",
            "telephone_number": "303-425-9245",
            "fax_number": "303-425-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3885 UPHAM ST",
            "address_2": "SUITE 200",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334880",
            "telephone_number": "303-425-9245",
            "fax_number": "303-425-1378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHERINE",
        "middle_name": "MIRRO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CO",
            "license": "53932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjohnson@widc.careclouddirect.com",
            "affiliation": "N",
            "endpointDescription": "KJohnson WIDC Direct Email Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3885 Upham St",
            "address_2": "Suite 200",
            "city": "Wheat Ridge",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800334880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "MIRRO",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wheat Ridge, CO

Sources for this page

Verify at the official NPI Registry.