Kimberely Dawn Johnson, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN168872 Issued in GA

Practice address

827 Ga Highway 93 N
Cairo, GA 39827-5729

Phone

(229) 225-7238

Fax

(229) 377-0832

NPI assigned

Aug 8, 2018

Last updated

Aug 8, 2018By 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

Enrolled in GA, FL2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Port Medical Management IncGroup PAC ID 8729418454, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5086/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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Port Medical Management Inc

  dba The Bridge

  • Family Medicine Physician
  • Bainbridge, GA
  • NPI 1932731361
  Medicare reassignment Care Compare group NPD
• Rural Urgent Care LLC

  dba MainStreet Family Care

  • Urgent Care Clinic/Center
  • Quincy, FL
  • NPI 1881353670
  Medicare reassignment NPD
• Rural Urgent Care LLC

  • Urgent Care Clinic/Center
  • Centre, AL
  • NPI 1932586476

  GA

  Medicare reassignment NPD
• Angels of Grace Community Wellness Center, Inc.

  • Clinic/Center
  • Cairo, GA
  • NPI 1154810844
  NPD
• Rural Urgent Care LLC

  dba MainStreet Family Care

  • Rural Health Clinic/Center
  • Eufaula, AL
  • NPI 1588450316
  NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1215416516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 GA HIGHWAY 93 N",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398275729",
            "telephone_number": "229-225-7238",
            "fax_number": "229-377-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 GA HIGHWAY 93 N",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398275729",
            "telephone_number": "229-225-7238",
            "fax_number": "229-377-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIMBERELY",
        "middle_name": "DAWN",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN168872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer W. Kendrick DMD, LLC (Dental Associates of Southwest Georgia)
• John D. Archbold Memorial Hospital, Inc. (Archbold - Grady Specialty Clinic)
• John D. Archbold Memorial Hospital, Inc. (Grady County Dialysis Facility)
• Chandra A Johnson, LCSW
• Guy Johnson III, D.C.
• Luisa Johnson, APRN
• Shenkia Isadora Johnson, LPN
• Katherine T Kelley, CRNA
• Jennifer Kendrick, D.M.D.
• Kenneth Harrison Medical LLC

• Family Nurse Practitioner in Cairo, GA
• Providers in Cairo, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.