NPIMap

Individual provider Active NPI

Katelyn Admire Johnson, P.A.C.

  • Physician Assistant
  • Galena, KS
National Provider Identifier
1528684388
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
444 Four States Dr
Galena, KS 66739-4324
Phone
(620) 783-4441
NPI assigned
Jun 17, 2020
Last updated
Jan 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4398 OK
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

444 Four States Dr
Galena, KS 66739-4324

Mailing address

444 Four States Dr
Galena, KS 66739-4324
Phone (620) 783-4441

Other practice location 1

1717 S Range Line Rd
Joplin, MO 64804-3234
Phone (417) 556-2040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, KS, MO3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200921001504 OK Practitioner - Physician Assistant 2062830235 Reassigns benefits to 3 organizations
I20260227001538 KS Practitioner - Physician Assistant 2062830235 Reassigns benefits to 1 organization
I20260227002290 MO Practitioner - Physician Assistant 2062830235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Pennsylvania State University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, shared by 3 NPIs, 288 clinicians

Practice addresses (Care Compare)

1717 S Range Line Rd B
Mercy Convenient Care
Joplin, MO 64804-3224
Phone (417) 623-2207

444 Four States Dr
Suite 1
Galena, KS 66739-4325
Phone (877) 783-4441

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4398OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Joplin LLC CurrentSince Jan 26, 2026 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Jan 20, 2026 Accepting new patients
Integris Grove Hospital Past Accepting new patients

Locations

403 Woodland Hills Blvd
Fort Scott, KS 66701
Phone (417) 556-4762

444 Four States Dr
Ste 1
Galena, KS 66739
Phone (877) 783-4441

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

1717 S Range Line Rd
Ste B
Joplin, MO 64804
Phone (417) 556-2231

Interoperability endpoints

  • Direct secure messaging: kadmire294526@ahs.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1528684388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 FOUR STATES DR",
            "city": "GALENA",
            "state": "KS",
            "postal_code": "667394324",
            "telephone_number": "620-783-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 FOUR STATES DR",
            "city": "GALENA",
            "state": "KS",
            "postal_code": "667394324",
            "telephone_number": "620-783-4441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1717 S Range Line Rd",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648043234",
            "country_code": "US",
            "telephone_number": "417-556-2040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATELYN",
        "middle_name": "ADMIRE",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4398",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galena, KS

Sources for this page

Verify at the official NPI Registry.