Kimberly Johnson, RN, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

310859 Issued in NY

Practice address

445 Broadhollow Rd Ste 25
Melville, NY 11747-3645

Phone

(631) 223-8852

Fax

(631) 350-0331

NPI assigned

Mar 25, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

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.

• BK Goyal MD PC

  • Infectious Disease Physician
  • Amityville, NY
  • NPI 1043759525
  Medicare reassignment NPD
• Definition Home Care, LLC

  • Nursing Care Agency
  • Brentwood, NY
  • NPI 1659097558
  NPD Authorized official
• KJ Wellness NP in Adult Health PLLC

  • Nurse Practitioner
  • Melville, NY
  • NPI 1740140664
  NPD Authorized official
• Klearscin Holistic LLC

  • Nurse Practitioner
  • Melville, NY
  • NPI 1437019932
  NPD Authorized official

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1295197523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 SUFFOLK AVE",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174202",
            "telephone_number": "631-336-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 BROADHOLLOW RD STE 25",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473645",
            "telephone_number": "631-223-8852",
            "fax_number": "631-350-0331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Broadway",
            "address_purpose": "LOCATION",
            "city": "Amityville",
            "state": "NY",
            "postal_code": "117012719",
            "country_code": "US",
            "telephone_number": "631-789-2020",
            "fax_number": "631-789-5669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIMBERLY",
        "credential": "RN, NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-25",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "321125",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "655384",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "661348",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "310859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shavon Queenie Johns
• Adrianna Rose Johnson
• Amhoy Johnson
• Britany Johnson
• Felicity Johnson
• Michael Shane Johnson
• Shanel Johnson
• Tamelia Antonette Johnson
• Lauren Michele Johnston, PT, DPT
• Heather Jonas, PH.D.

• Adult Health Nurse Practitioner in Melville, NY
• Providers in Melville, 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 Nov 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.