Active NPI
Kenneth H Johnson, DO
- Neuromusculoskeletal Medicine & OMM Physician
- Athens, OH
National Provider Identifier
1518929538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuromusculoskeletal Medicine & OMM Physician
- License
- 1437
- Practice address
- 2 Health Center Dr
Athens, OH 45701-2907 - Phone
- (740) 593-1660
- Fax
- (740) 593-0179
- NPI assigned
- Apr 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuromusculoskeletal Medicine & OMM Physician | 204D00000X | 1437 | ME | Primary |
| Family Medicine Physician | 207Q00000X | 1437 | ME |
Addresses
Primary practice location
2 Health Center Dr
Athens, OH 45701-2907
Mailing address
2 Health Center Dr
Athens, OH 45701-2907
Phone (740) 593-1660
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 212530099 | Medicaid | ME | |
| 010211810001 | Other | ME | TRICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1437 | ME | MD | Neuromusculoskeletal Medicine & OMM Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Norumbega Medical Specialists, LTD | Past | Accepting new patients | |
| Eastern Maine Medical Center | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Bangor, ME
- NPI 1790789147
-
- Health Service Clinic/Center
- Brewer, ME
- NPI 1780821140
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468972800000",
"number": "1518929538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 HEALTH CENTER DR",
"city": "ATHENS",
"state": "OH",
"postal_code": "457012907",
"telephone_number": "740-593-1660",
"fax_number": "740-593-0179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 HEALTH CENTER DR",
"city": "ATHENS",
"state": "OH",
"postal_code": "457012907",
"telephone_number": "740-593-1660",
"fax_number": "740-593-0179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KENNETH",
"middle_name": "H",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-05",
"last_updated": "2016-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "204D00000X",
"taxonomy_group": "",
"desc": "Neuromusculoskeletal Medicine & OMM",
"state": "ME",
"license": "1437",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ME",
"license": "1437",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "212530099",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "010211810001",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Athens, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.