Individual provider Active NPI

Kathryn Quinn Johnson, D.O.

  • Psychiatry Physician
  • Roanoke, VA
National Provider Identifier
1356787873
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0102204723 Issued in VA
Practice address
1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone
(540) 981-7000
NPI assigned
May 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 1533-320 WI
Psychiatry Physician 2084P0800X 0102204723 VA Primary
Psychiatry Physician 2084P0800X 036161995 IL

Addresses

Primary practice location

1906 Belleview Ave SE
Roanoke, VA 24014-1838

Mailing address

5217 Hawkbill Cir
Roanoke, VA 24018-8626
Phone (269) 352-2406

Other practice location 1

1204 N Mound St
Nacogdoches, TX 75961-4027
Phone (936) 564-4611

Other practice location 2

11708 Nickelsville Hwy Ste 200
Nickelsville, VA 24271-2872
Phone (276) 248-1880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, IA, WI, WV, DC, AR, PA, OK, OH, IL10 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 10

Enrollment IDStateProvider typePAC IDDetails
I20170626001008 VA Practitioner - Psychiatry 7012142953 Reassigns benefits to 1 organization
I20210907000129 IA Practitioner - Psychiatry 7012142953 Reassigns benefits to 2 organizations
I20211110001491 WI Practitioner - Psychiatry 7012142953 Reassigns benefits to 3 organizations
I20220411000030 WV Practitioner - Psychiatry 7012142953 Reassigns benefits to 1 organization
I20221003001020 DC Practitioner - Psychiatry 7012142953
I20230323002662 AR Practitioner - Psychiatry 7012142953 Reassigns benefits to 1 organization
I20240401003172 PA Practitioner - Psychiatry 7012142953 Reassigns benefits to 1 organization
I20260102003541 OK Practitioner - Psychiatry 7012142953 Reassigns benefits to 1 organization
I20260327000632 OH Practitioner - PsychiatryPractitioner - Addiction Medicine 7012142953 Reassigns benefits to 1 organization
I20260604001268 IL Practitioner - Psychiatry 7012142953 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
West Virginia School of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

123 Hospital Dr
Suite 110
Watertown, WI 53098-3320
Phone (920) 262-4800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036161995ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wisconsin Lutheran Child and Family Service Inc CurrentSince Jun 2, 2022 Accepting new patients
Team Mentation PLLC CurrentSince Aug 1, 2023 Accepting new patients
Northeast Iowa Mental Health Center CurrentSince Jun 28, 2022 Accepting new patients
Evizzit of Iowa Psychiatry PC Psychiatry CurrentSince Jul 26, 2021 Accepting new patients
Davis Memorial Hospital CurrentSince Jan 21, 2022 Accepting new patients
Watertown Physician Practices LLC Current Accepting new patients
Family Insight Inc CurrentSince Aug 1, 2022 Accepting new patients
Watertown Physician Practices LLC CurrentSince Dec 15, 2021 Accepting new patients
Davis Memorial Hospital CurrentSince Jan 21, 2022 Accepting new patients
Suburban Medical Group LLC CurrentSince Feb 12, 2024 Accepting new patients
Evizzit of Iowa Psychiatry PC PastSince Dec 26, 2021 Accepting new patients
United Community Services, Inc. PastSince Jun 28, 2022 Accepting new patients

Locations

1 Medical Park Dr
Bryant, AR 72015
Phone (501) 776-6000

770 Tanglefoot Ln
Bettendorf, IA 52722
Phone (563) 241-7443

905 Montgomery St
Decorah, IA 52101
Phone (563) 382-3649

1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200

36 S Frederick Ave
Oelwein, IA 50662
Phone (319) 283-5774

1501 42nd St
Ste 575
West Des Moines, IA 50266
Phone 8552703625171

1501 42nd St
Ste 120
West Des Moines, IA 50266

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

207 E F St
Okeene, OK 73763
Phone (580) 822-4321

2701 DeKalb Pike
Fl 2
East Norriton, PA 19401
Phone (610) 275-1028

8 Cadillac Dr
Ste 230
Brentwood, TN 37027
Phone (615) 647-0750

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

10640 Page Ave
Ste 220
Fairfax, VA 22030
Phone (703) 310-7665

11708 Nickelsville Hwy
Ste 200
Nickelsville, VA 24271
Phone (276) 248-1880

6800 Paragon Pl
Ste 200
Richmond, VA 23230
Phone (757) 768-6914

711 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-1302

W175N11120 Stonewood Dr
Germantown, WI 53022
Phone (262) 345-5533

5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089

9555 S Howell Ave
Oak Creek, WI 53154
Phone (262) 345-5560

323 S 18th Ave
Sturgeon Bay, WI 54235
Phone (920) 743-5566

1507 Doctors Ct
Watertown, WI 53094
Phone (920) 261-4111

123 Hospital Dr
Ste 110
Watertown, WI 53098
Phone (920) 261-0672

812 Gorman Ave
Elkins, WV 26241
Phone (304) 636-3300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FABHDD
  • Direct secure messaging: kathryn.johnson@546238333255684.direct.elationemr.com

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1356787873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5217 HAWKBILL CIR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240188626",
            "telephone_number": "269-352-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-981-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1204 N Mound St",
            "address_purpose": "LOCATION",
            "city": "Nacogdoches",
            "state": "TX",
            "postal_code": "759614027",
            "country_code": "US",
            "telephone_number": "936-564-4611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11708 Nickelsville Hwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Nickelsville",
            "state": "VA",
            "postal_code": "242712872",
            "country_code": "US",
            "telephone_number": "276-248-1880",
            "fax_number": "276-258-0616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHRYN",
        "middle_name": "QUINN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-13",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "1533-320",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0102204723",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036161995",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.