Active NPI
Kathleen O'Hara Johnson, M.D.
- Internal Medicine Physician
- Riverdale, GA
National Provider Identifier
1386922441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 40426
- Practice address
- 6330 Riverdale Rd
Riverdale, GA 30274-1617 - Phone
- (770) 994-7400
- NPI assigned
- Jul 23, 2011
- Last updated
- Jul 23, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 40426 | GA | Primary |
Addresses
Primary practice location
6330 Riverdale Rd
Riverdale, GA 30274-1617
Mailing address
6330 Riverdale Rd
Riverdale, GA 30274-1617
Phone (770) 994-7400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40426 | GA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Medical Clinics, P.C. | Past | Accepting new patients | |
| Vision Medical Consulting, P.C. | Past | Accepting new patients |
Organizations & group practices 2
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311379200000",
"number": "1386922441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6330 RIVERDALE RD",
"city": "RIVERDALE",
"state": "GA",
"postal_code": "302741617",
"telephone_number": "770-994-7400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6330 RIVERDALE RD",
"city": "RIVERDALE",
"state": "GA",
"postal_code": "302741617",
"telephone_number": "770-994-7400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KATHLEEN",
"middle_name": "O'HARA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-23",
"last_updated": "2011-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "40426",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverdale, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.