Kelly Lynn Johnson, CPT

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

License

CPT-002894 Issued in OR

Practice address

2130 Marcola Rd
Springfield, OR 97477-2592

Phone

(541) 747-3362

Fax

(541) 741-2287

NPI assigned

Jul 12, 2021

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

• Kelley Lynn Johnson Other name

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": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1417529272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 DAISY ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974786797",
            "telephone_number": "541-912-2563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 MARCOLA RD",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974772592",
            "telephone_number": "541-747-3362",
            "fax_number": "541-741-2287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "credential": "CPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "OR",
            "license": "CPT-002894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "JOHNSON",
            "middle_name": "LYNN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Eric Johnsen, PA-C
• Christy L Johnson
• Eric Anders Johnson, M.D.
• Janet Lynn Johnson, QMHA
• Joyce Johnson, L.D.
• Matthew Johnson, DDS
• Monica Johnson
• Sophia Loren Johnson, PHARMD
• Georgia Johnston
• Karen F Johnston, LCSW

• Pharmacy Technician in Springfield, OR
• Providers in Springfield, OR by specialty
• Pharmacy Technician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.