Active NPI
Kylie Johnson, RD
- Registered Dietitian
- Greenville, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD.7703
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| LD.7703 | OH | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Health Services of Darke County Inc | Current | Accepting new patients | |
| Family Health Services of Darke County, Inc. | Current | Accepting new patients | |
| Family Health Services of Darke County, Inc. | Current | 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
- 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.
-
- Federally Qualified Health Center (FQHC)
- Versailles, OH
- NPI 1013244680
OH
-
- Student Health Clinic/Center
- New Madison, OH
- NPI 1477244275
-
- Primary Care Clinic/Center
- New Madison, OH
- NPI 1730593336
-
- Primary Care Clinic/Center
- Greenville, OH
- NPI 1750106522
-
- Federally Qualified Health Center (FQHC)
- Greenville, OH
- NPI 1013361583
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.