Kevin Russell Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA04026 Issued in TX

Practice address

5201 Harry Hines Blvd
Dallas, TX 75235-7708

Phone

(817) 343-0431

NPI assigned

Jul 19, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

AIDS Arms, Inc.Group PAC ID 7719940774, 18 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.1 of 100Reported as group

Quality

88.97

Promoting interoperability

79

Improvement activities

40

Cost

83.75

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevin.johnson.1@29669.direct.athenahealth.com
• Direct secure messaging: kjohnson29296@direct.phhs.org

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.

• AIDS Arms, Inc.

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1609852813
  Medicare reassignment Care Compare group NPD
• AIDS Arms, Inc.

  • General Practice Dentistry
  • Dallas, TX
  • NPI 1841986999
  NPD

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1194745877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5541 GOODWIN AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752066212",
            "telephone_number": "817-343-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357708",
            "telephone_number": "817-343-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KEVIN",
        "middle_name": "RUSSELL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "PA04026",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX DPS #",
            "identifier": "Y0133663",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth B Johnson, MD
• Kenneth R Johnson
• Keondra C Johnson
• Kerry R Johnson, M.D.
• Keshaun Antoinette Johnson
• Kevin Wayne Johnson, CRNA
• Kiana Johnson, CHW
• Kieona Johnson
• Kimberly Dionne Johnson, D.O.
• Kimberly Kaye Johnson, D.C.

• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.