Kenneth Johnson

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

204 10TH Ave S
Nampa, ID 83651-3832

Phone

(208) 466-2229

Fax

(208) 466-2667

NPI assigned

Oct 20, 2025

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)

Not enrolled

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

{
    "created_epoch": "1760918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1134096662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 10TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513832",
            "telephone_number": "208-466-2229",
            "fax_number": "208-466-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 10TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513832",
            "telephone_number": "208-466-2229",
            "fax_number": "208-466-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KENNETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-20",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corey Lynn Johnson
• Elizabeth Johnson, RD
• John A. Johnson, MD
• Joy Gayle Johnson, O.D.
• Juli Eileen Johnson, LPC
• Keri Johnson
• Lisa Johnson, LCPC
• Lyndzee Johnson, LMSW
• Matthew Johnson, CPHT
• Miers C Johnson, MD

• Community Health Worker in Nampa, ID
• Providers in Nampa, ID by specialty
• Community Health Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.