Individual provider Active NPI

Kyle S Johnson, MD

  • Family Medicine Physician
  • Tuscaloosa, AL
National Provider Identifier
1124609664
Registry record updated Oct 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD49123 Issued in AL
Practice address
850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7457
Phone
(205) 348-1770
NPI assigned
Apr 16, 2021
Last updated
Oct 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2026

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 BP10074829 TX
Family Medicine Physician 207Q00000X MD49123 AL Primary

Addresses

Primary practice location

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7457

Mailing address

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7457
Phone (205) 348-1770

Other practice location 1

1195 Garner Field Rd Ste 500
Uvalde, TX 78801-4861
Phone (830) 278-3027

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240722003765 AL Practitioner - Family Practice 0244639326 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas a & M University System, HSC, College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Whatley Health Services IncGroup PAC ID 8224921705, 84 clinicians

Practice addresses (Care Compare)

2731 ML King Jr Blvd
Tuscaloosa, AL 35401-5235
Phone (205) 758-6647

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7457
Phone (205) 348-1770

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD49123ALMDFamily Medicine Physician
BP10074829TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Whatley Health Services Inc CurrentSince Jul 29, 2024 Accepting new patients
Capstone Health Services Foundation PC CurrentSince Jul 1, 2024 Accepting new patients
Whatley Health Services, Inc. CurrentSince Jul 29, 2024 Accepting new patients
Capstone Health Services Foundation PC Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
The DCH Healthcare Authority Past Accepting new patients

Locations

6205 Jemison Ln
Northport, AL 35476
Phone (205) 348-6122

2731 Ml King Jr Blvd
Tuscaloosa, AL 35401
Phone (205) 349-3250

850 Peter Bryce Blvd
Tuscaloosa, AL 35401

Interoperability endpoints

  • Direct secure messaging: kyle.johnson.p1@direct.umc.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792540800000",
    "number": "1124609664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 PETER BRYCE BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017457",
            "telephone_number": "205-348-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 PETER BRYCE BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017457",
            "telephone_number": "205-348-1770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1195 Garner Field Rd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Uvalde",
            "state": "TX",
            "postal_code": "788014861",
            "country_code": "US",
            "telephone_number": "830-278-3027",
            "fax_number": "830-278-3089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KYLE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-16",
        "last_updated": "2026-10-21",
        "certification_date": "2026-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10074829",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD49123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.