Individual provider Active NPI

Kelly Marie McGee Johnson, D.C.

  • Chiropractor
  • Sarasota, FL
National Provider Identifier
1376194662
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
04922 Issued in OH
Practice address
3544 Clark Rd
Sarasota, FL 34231-8408
Phone
(941) 404-1253
NPI assigned
Sep 27, 2019
Last updated
Jan 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 04922 OH Primary

Addresses

Primary practice location

3544 Clark Rd
Sarasota, FL 34231-8408

Mailing address

308 Cantabria TRL
Bradenton, FL 34208-1586
Phone (740) 243-9923

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211015002741 FL Practitioner - Chiropractic 3678984119 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04922OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Revitalize Chiropractic LLC Chiropractor CurrentSince Sep 23, 2024 Accepting new patients
Dr David L Hartz PA Chiropractor CurrentSince Sep 1, 2021 Accepting new patients
McGee Chiropractic Center, LLC Chiropractor PastSince Jul 31, 2020 Accepting new patients

Locations

3544 Clark Rd
Sarasota, FL 34231
Phone (941) 404-1253

1610 W Plaza Dr
Tallahassee, FL 32308
Phone (850) 445-2396

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1376194662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 CANTABRIA TRL",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081586",
            "telephone_number": "740-243-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3544 CLARK RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342318408",
            "telephone_number": "941-404-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KELLY",
        "middle_name": "MARIE MCGEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-27",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "04922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.