Kennethia Johnson

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

247 SW Port St Lucie Blvd
Port St Lucie, FL 34984-5015

Phone

(772) 207-1356

NPI assigned

Aug 23, 2018

Last updated

Feb 28, 2022By the provider in NPPES

Sex

Female

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

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": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1164903548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 NW HATCHES HARBOR RD APT 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349834124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 SW PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349845015",
            "telephone_number": "772-207-1356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KENNETHIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-23",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Ann Johnsen, ARNP
• Chelsey Johnson, MS CCC-SLP
• Dorsena Johnson
• Janae Johnson, LCSW
• John W Johnson, RPT
• Michelle Johnson, APRN
• Taisha Johnson, APRN, NP-C
• Hillary Michelle Johnston
• Derwin Jones, LICENSED OPTICIAN
• Erica Jones

• Behavior Technician in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; 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.