Individual provider Active NPI

Katherine E. Johnson, M.D.

  • Internal Medicine Physician
  • Kenton, OH
National Provider Identifier
1508912361
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-067998 Issued in OH
Practice address
60 Washington Blvd
Kenton, OH 43326-2080
Phone
(419) 673-8689
Fax
(419) 673-9492
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-067998 OH Primary

Addresses

Primary practice location

60 Washington Blvd
Kenton, OH 43326-2080

Mailing address

5350 Frantz Rd
Dublin, OH 43016-4259

Other identifiers 2

IdentifierTypeStateIssuer
2326754MedicaidOH
0145122MedicaidOH

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20100104000272 OH Practitioner - Internal Medicine 8628980927 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-067998OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation Internal Medicine CurrentSince May 25, 2014 Accepting new patients
Ohiohealth Corporation CurrentSince May 25, 2014 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

5350 Frantz Rd
Dublin, OH 43016

921 E Franklin St
Kenton, OH 43326
Phone (419) 673-0761

60 Washington Blvd
Kenton, OH 43326
Phone (419) 673-8689

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417996800000",
    "number": "1508912361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 FRANTZ RD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 WASHINGTON BLVD",
            "city": "KENTON",
            "state": "OH",
            "postal_code": "433262080",
            "telephone_number": "419-673-8689",
            "fax_number": "419-673-9492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHERINE",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2014-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-067998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2326754",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0145122",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenton, OH

Sources for this page

Verify at the official NPI Registry.