Individual provider Active NPI

Kaitlyn Johnson

  • Physician Assistant
  • Lynchburg, VA
National Provider Identifier
1528956240
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1501 Lakeside Dr
Lynchburg, VA 24501-3113
Phone
(434) 544-8100
NPI assigned
Jun 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1501 Lakeside Dr
Lynchburg, VA 24501-3113

Mailing address

1501 Lakeside Dr
Lynchburg, VA 24501-3113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251215001709 VA Practitioner - Physician Assistant 9032603261 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2528 Buffalo Mill Rd
Evington, VA 24550-4252

4535 Dressler Rd NW
Canton, OH 44718-2545

4535 Dressler Rd W
Canton, OH 44718-2545

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince Nov 1, 2025 Accepting new patients
Alexandria Springfield Emergency Physicians PC CurrentSince Dec 2, 2025 Accepting new patients
Alexandria Springfield Emergency Physicians PC CurrentSince Dec 2, 2025 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Nov 1, 2025 Accepting new patients

Locations

60 E Roslyn Ct
Colonial Hgts, VA 23834
Phone (804) 281-8100

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1528956240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 LAKESIDE DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245013113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 LAKESIDE DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245013113",
            "telephone_number": "434-544-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.