Active NPI
Kimberly Susan Johnson, M.D.
- Pediatrics Physician
- Tyndall Afb, FL
National Provider Identifier
1285600437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 024311
- Practice address
- 340 Magnolia Circle
Tyndall Afb, FL 32403-5612 - Phone
- (850) 283-7678
- Fax
- (850) 283-7620
- NPI assigned
- Feb 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 024311 | LA | Primary |
Addresses
Primary practice location
340 Magnolia Circle
Tyndall Afb, FL 32403-5612
Mailing address
1214 Huntington Ridge Rd
Lynn Haven, FL 32444-3189
Phone (850) 814-7987
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024311 | LA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1285600437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1214 HUNTINGTON RIDGE RD",
"city": "LYNN HAVEN",
"state": "FL",
"postal_code": "324443189",
"telephone_number": "850-814-7987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 MAGNOLIA CIRCLE",
"city": "TYNDALL AFB",
"state": "FL",
"postal_code": "324035612",
"telephone_number": "850-283-7678",
"fax_number": "850-283-7620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KIMBERLY",
"middle_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-27",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "LA",
"license": "024311",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyndall Afb, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.