Kimberly L Johnson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5005051 Issued in NC

Practice address

131 Welton Way
Mooresville, NC 28117-9163

Phone

(704) 360-4564

Fax

(704) 360-4553

NPI assigned

Aug 11, 2010

Last updated

Aug 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Carolina Pain and Weight Loss, PAGroup PAC ID 7113168824, 8 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.03 of 100Reported as group

Quality

90

Promoting interoperability

98

Improvement activities

40

Cost

74.09

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Carolina Pain and Weight Loss

  • Pain Medicine Physician
  • Mooresville, NC
  • NPI 1598101974

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• City of New York Office of Payroll Administration

  • State or Local Public Health Clinic/Center
  • Jackson Heights, NY
  • NPI 1942257035
  Medicare reassignment NPD
• Carolina Pain and Weight Loss, PA

  • Pain Medicine Physician
  • Salisbury, NC
  • NPI 1932936226

  Nurse Practitioner

  NPD
• City of New York Office of Payroll Administration

  dba New York City Department of Health & Mental Hygienes Manhattanville H

  • Community Health Clinic/Center
  • New York, NY
  • NPI 1659327674
  NPD
• City of New York Office of Payroll Administration

  dba New York City Dept of Health & Mental Hygiene Fort Green District Heal

  • State or Local Public Health Clinic/Center
  • Brooklyn, NY
  • NPI 1982624276
  NPD
• City of New York Office of Payroll Administration

  dba NYC DOHMH Crown Heights HC

  • State or Local Public Health Clinic/Center
  • Brooklyn, NY
  • NPI 1679501647
  NPD (past)
• City of New York Office of Payroll Administration

  dba NYCDOHMH Bushwick District

  • Community Health Clinic/Center
  • Brooklyn, NY
  • NPI 1912953035
  NPD (past)

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1518272707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 WELTON WAY",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179163",
            "telephone_number": "704-360-4564",
            "fax_number": "704-360-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 WELTON WAY",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179163",
            "telephone_number": "704-360-4564",
            "fax_number": "704-360-4553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1218 Prospect Pl",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112132211",
            "country_code": "US",
            "telephone_number": "718-953-8211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIMBERLY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F0709387",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "336144",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5005051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1518272707",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John E Latz MD PLLC
• Brittany Evelyn Johnson, C.P.
• Chantel Vantrice Johnson
• Emily Lynne Johnson, NP
• John Anthony Johnson, D.M.D., M.D.
• Matthew Jeffrey Johnson Jr., MD
• Matthew Jeffrey Johnson, MD, DMD
• Stephanie Nicole Johnson
• Andrew C Jones, RDN, LDN
• Jennifer W Jones, DPT

• Family Nurse Practitioner in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.