Kelly Elizabeth Johnson

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

License

829622 Issued in TX

Practice address

602 W Semands St
Conroe, TX 77301-1867

Phone

(936) 443-2250

NPI assigned

Sep 26, 2018

Last updated

Sep 26, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1295210136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3547 FALCON WAY",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044880",
            "telephone_number": "936-443-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 W SEMANDS ST",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011867",
            "telephone_number": "936-443-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "TX",
            "license": "829622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John M. Fackler M.D. PA
• John N Ugwu (Hilltop EMS)
• Carol Ainsley Johnson, LVN
• Constance Johnson
• Devyn Johnson
• Lindsey Johnson, LPC
• Luke Johnson
• Mark Alan Johnson, MD
• Mary Beth Johnson, M.S.,CCC-SLP
• Michelle Melito Johnson, OTR, CHT

• Medical-Surgical Registered Nurse in Conroe, TX
• Providers in Conroe, TX by specialty
• Medical-Surgical Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.