Kenneth Johnson

Primary specialty

DriverTaxonomy code 172A00000X

License

000022128241 Issued in NC

Practice address

115 Spring Glenn CT
Rocky Mount, NC 27803-8010

Phone

(252) 469-9363

NPI assigned

Aug 19, 2021

Sex

Male

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

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": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1316613359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 SPRING GLENN CT",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278038010",
            "telephone_number": "252-469-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 SPRING GLENN CT",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278038010",
            "telephone_number": "252-469-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KENNETH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-19",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Driver",
            "state": "NC",
            "license": "000022128241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Burnette Johnson, DMD
• Ciera Johnson
• Felicia Johnson, LPN
• H. Mike Johnson, O.D.
• Karen Johnson, CNM
• Sue Johnson, PT
• Winnie Johnson, MS-CCCSLP
• Amanda Johnston, PT
• Barbara Dawn Johnston, BS/MS
• Jomko Haus, LLC

• Driver in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Driver in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.