Mary Johanson

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

TP529 Issued in KY

Practice address

2201 Lexington Ave
Ashland, KY 41101-2843

Phone

(606) 408-4000

NPI assigned

Mar 20, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Pediatric Medicine

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kings Daughters Medical Specialties IncGroup PAC ID 6103968029, 397 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• King'S Daughters' Medical Center Hospital, Ashland, KY, CCN 180009

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Kings Daughters Medical Specialties Inc

  • Physical Medicine & Rehabilitation Physician
  • Prestonsburg, KY
  • NPI 1710215736

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• King'S Daughters Medical Specialties, Inc.

  • Obstetrics & Gynecology Physician
  • Ashland, KY
  • NPI 1174287270
  NPD
• Kings Daughters Medical Specialties Inc

  • Radiation Oncology Physician
  • Ashland, KY
  • NPI 1699565176
  NPD
• Ashland Hospital Corporation

  • General Acute Care Hospital
  • Ashland, KY
  • NPI 1851346720
  NPD (past)

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

• Ashland Hospital Corporation

  • General Acute Care Hospital
  • Ashland, KY
  • NPI 1851346720
  Care Compare affiliation

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

{
    "created_epoch": "1616198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1194301192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 DUBLIN DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585036424",
            "telephone_number": "701-527-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 LEXINGTON AVE",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012843",
            "telephone_number": "606-408-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSON",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-20",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "TP529",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "TP529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerald M. Ford, M.D., PSC
• Jerod Darnell DPM PLLC
• Taylor Jimison
• Elaine B. Jividen, ARNP
• Joel M Cost DDS PLLC
• John W Morton, O.D.,P.S.C.
• Winfield Clinton John III, DMD
• Arianna Johnson
• Audrey Johnson
• Dana Allen Johnson, M.D.

• Pediatrics Physician in Ashland, KY
• Providers in Ashland, KY by specialty
• Pediatrics Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.