Individual provider Active NPI

Kylie Johnson, RD

  • Registered Dietitian
  • Greenville, OH
National Provider Identifier
1558044123
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD.7703 Issued in OH
Practice address
1101 Jackson St
Greenville, OH 45331-1395
Phone
(937) 547-2319
NPI assigned
Aug 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD.7703 OH Primary

Addresses

Primary practice location

1101 Jackson St
Greenville, OH 45331-1395

Mailing address

5735 Meeker Rd
Greenville, OH 45331-1186
Phone (937) 548-9680

Other practice location 1

5735 Meeker Rd
Greenville, OH 45331-1186
Phone (937) 548-9680

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230830000987 OH Practitioner - Registered Dietitian Or Nutrition Professional 4789047374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Services of Darke County, Inc.Group PAC ID 5698762235, 57 clinicians

Practice addresses (Care Compare)

10484 Kley Rd
Versailles, OH 45380-9561
Phone (937) 526-3016

5735 Meeker Rd
Greenville, OH 45331-1180
Phone (937) 548-9680

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LD.7703OHMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Services of Darke County Inc Current Accepting new patients
Family Health Services of Darke County, Inc. CurrentSince Aug 14, 2023 Accepting new patients
Family Health Services of Darke County, Inc. CurrentSince Aug 14, 2023 Accepting new patients
Family Health Services of Darke County, Inc. Past Accepting new patients

Locations

1101 Jackson St
Ste C
Greenville, OH 45331
Phone (937) 547-2319

5735 Meeker Rd
Greenville, OH 45331
Phone (937) 548-3806

10484 Kley Rd
Versailles, OH 45380
Phone (937) 526-3016

Interoperability endpoints

  • Direct secure messaging: kylie.johnson@fhsi.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1558044123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5735 MEEKER RD",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453311186",
            "telephone_number": "937-548-9680",
            "fax_number": "937-548-2087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 JACKSON ST",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453311395",
            "telephone_number": "937-547-2319"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5735 Meeker Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "OH",
            "postal_code": "453311186",
            "country_code": "US",
            "telephone_number": "937-548-9680",
            "fax_number": "937-548-2087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KYLIE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "LD.7703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.