Kenneth Ian Johnson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME73635 Issued in FL

Practice address

8505 20TH St
Vero Beach, FL 32966-1705

Phone

(772) 257-8224

Fax

(772) 252-3245

NPI assigned

Oct 12, 2005

Last updated

Aug 6, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Treasure Coast Community Health IncGroup PAC ID 4082625827, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Indian River Hospital Hospital, Vero Beach, FL, CCN 100105

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JICADA

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.

• Treasure Coast Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Fellsmere, FL
  • NPI 1891740916
  Medicare reassignment Care Compare group NPD
• Treasure Coast Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Vero Beach, FL
  • NPI 1609686542
  NPD
• Treasure Coast Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Vero Beach, FL
  • NPI 1649721341
  NPD
• Access Health Care LLC

  • Family Medicine Physician
  • Beverly Hills, FL
  • NPI 1043453020
  NPD (past)
• Advanced Heart Group PL

  dba Advanced Cardiopulmonary & Medical Consultants

  • Cardiovascular Disease Physician
  • Daytona Beach, FL
  • NPI 1720247984
  NPD (past)
• Metcare of Florida, Inc

  dba Conviva Care Center

  • Internal Medicine Physician
  • Port Orange, FL
  • NPI 1619433869
  NPD (past)
• Metcare of Florida, Inc

  dba Conviva Care Center

  • Internal Medicine Physician
  • Hialeah, FL
  • NPI 1902893225
  NPD (past)
• Omni Healthcare, Inc.

  • Specialist
  • Melbourne, FL
  • NPI 1134191323

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indian River Memorial Hospital Inc

  dba Cleveland Clinic Indian River Hospital

  • General Acute Care Hospital
  • Vero Beach, FL
  • NPI 1376512988
  Care Compare affiliation

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1457349508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 INDIAN RIVER BLVD STE B210",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607113",
            "telephone_number": "772-257-8224",
            "fax_number": "772-252-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8505 20TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329661705",
            "telephone_number": "772-257-8224",
            "fax_number": "772-252-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KENNETH",
        "middle_name": "IAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME73635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ME73635",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine A Johnson, RN, BSN
• Chloe Johnson
• Indley Johnson, MD
• Jenifer Rene Johnson
• Jimmy Dylan Johnson, D.M.D.
• Laura Lynn Johnson, M.D.
• Melissa Erin Johnson, P.T.
• Mitchell W Johnson, PA
• Ryan Maurice Johnson, MD
• Sherry Danielle Johnson, APRN

• Family Medicine Physician in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.