Kevin W Johnston, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F309196 Issued in NY

Practice address

33 Timbercrest LN
South Setauket, NY 11720-1243

Phone

(631) 922-5900

Fax

(631) 675-9002

NPI assigned

Dec 4, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24283/brand/1/csg/1/fhir/r4

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.

• KK NP in Adult Health LLP

  • Nurse Practitioner
  • Port Jefferson, NY
  • NPI 1588246466
  NPD

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

{
    "created_epoch": "1417651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1194122267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 TIMBERCREST LN",
            "city": "SOUTH SETAUKET",
            "state": "NY",
            "postal_code": "117201243",
            "telephone_number": "631-922-5900",
            "fax_number": "631-675-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 TIMBERCREST LN",
            "city": "SOUTH SETAUKET",
            "state": "NY",
            "postal_code": "117201243",
            "telephone_number": "631-922-5900",
            "fax_number": "631-675-9002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28 Jones St",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "East Setauket",
            "state": "NY",
            "postal_code": "117332941",
            "country_code": "US",
            "telephone_number": "631-922-5900",
            "fax_number": "631-675-9002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "KEVIN",
        "middle_name": "W",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-04",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "689209",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F309196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE OFFICE OF PROFESSIONS",
            "identifier": "F309196",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HomePC",
            "affiliation": "N",
            "endpointDescription": "Home",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "33 Timbercrest Ln",
            "city": "South Setauket",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117201243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kelsey Hung, DPT
• Alicia Mae Italiano, LCSW
• J Bleecher LCSW-PC
• McNamary H. Jean-Noel
• Crystal Lee Johnson, LMT
• France Kaplan, LPN
• Kapson Senior Quarters Corp. (South Setauket - AL)
• Zehra Khan, PHARM. D.
• Kratosdp
• Alison Kreush, LMSW

• Adult Health Nurse Practitioner in South Setauket, NY
• Providers in South Setauket, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.