Kay A Johnston, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

ME131008 Issued in FL

Practice address

16461 Domestic Ave
Fort Myers, FL 33912-6008

Phone

(877) 266-7768

Fax

(603) 952-3900

NPI assigned

Nov 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Suncoast Skin Solutions

  • Dermatology Physician
  • Lutz, FL
  • NPI 1487827416
  NPD (past)

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1417930652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3123 GREEN MEADOW DRIVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046977",
            "telephone_number": "325-944-3376",
            "fax_number": "325-944-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16461 DOMESTIC AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339126008",
            "telephone_number": "877-266-7768",
            "fax_number": "603-952-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "KAY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "K7307",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME131008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z000080R4",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lou Johnson, MD
• Sarah Johnson, PA-C
• Sarah A Johnson, O.D.
• Thomas Brian Johnson, MD
• Todd Johnson, DC
• Sujit Elias Johnston, DPM
• Joint Implant Surgeons of Florida PA
• Ann Melissa Jolivain, APRN
• Jon P Sipos DDS PA
• Jon P. Burdzy, D.O., P.a.

• MOHS-Micrographic Surgery Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• MOHS-Micrographic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.