Active NPI
Karen Ann Johnson, M.D.
- Family Medicine Physician
- Miramar, FL
National Provider Identifier
1114906963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 30212
- Practice address
- 3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308 - Phone
- (954) 399-4645
- Fax
- (855) 855-2792
- NPI assigned
- Jan 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 30212 | CO | Primary |
Addresses
Primary practice location
3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308
Mailing address
12201 Pecos St
Westminster, CO 80234-3888
Phone (303) 457-4497
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01302124 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vohra Wound Physicians of the West, P.C. | Family Medicine | Current | Accepting new patients |
| Rocky Mountain Primary Care , PC | Family Medicine | Past | Accepting new patients |
| Todd Dextradeur MD PC | Past | Accepting new patients |
Locations
3190 S Vaughn Way
Ste 550
Aurora, CO 80014
Phone (303) 955-8096
1960 S Fordham St
Longmont, CO 80503
Phone (719) 473-1105
3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Englewood, CO
- NPI 1205176096
-
- Family Medicine Physician
- Westminster, CO
- NPI 1215981634
-
- Internal Medicine Physician
- Thornton, CO
- NPI 1881864072
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476835200000",
"number": "1114906963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12201 PECOS ST",
"city": "WESTMINSTER",
"state": "CO",
"postal_code": "802343888",
"telephone_number": "303-457-4497",
"fax_number": "303-254-4369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 SW 160TH AVE",
"address_2": "SUITE 250",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330276308",
"telephone_number": "954-399-4645",
"fax_number": "855-855-2792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KAREN",
"middle_name": "ANN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-11",
"last_updated": "2016-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "30212",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01302124",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.