Kathleen M Johnson, MSN, PMHNP-BC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

202106762NP-PP Issued in OR

Practice address

132 E Broadway Ste 730
Eugene, OR 97401-3160

Phone

(303) 903-6681

NPI assigned

Jul 28, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kathleen M Johnson Professional name

Medicare fee-for-service enrollment

Enrolled in CO

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

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

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.

• Insight Northwest Recovery

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Eugene, OR
  • NPI 1992411052
  NPD (past)

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

{
    "created_epoch": "1501200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1366966616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 E BROADWAY STE 730",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013160",
            "telephone_number": "541-357-9433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 E BROADWAY STE 730",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013160",
            "telephone_number": "303-903-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "MSN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-28",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "202106762NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "JOHNSON",
            "middle_name": "M",
            "credential": "PMHNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jennifer Nicole Johnson
• Jon Johnson
• Jonathan Clate Johnson
• Karrie Johnson, PA-C
• Katharine Ann Johnson
• Laura Johnson
• Linsey Johnson
• Lisa Pauline Johnson, CMA
• Marla Deann Johnson, BACHELORS OF ARTS
• Michael David Johnson

• Psychiatry Physician in Eugene, OR
• Providers in Eugene, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.