Kiana Kimmjo Johnson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

305587 Issued in MN

Practice address

18643 Jonesboro CT
Lakeville, MN 55044-6500

Phone

(612) 708-9043

NPI assigned

Jan 4, 2020

Last updated

Jan 4, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: s.gracemn@google.com

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

{
    "created_epoch": "1578096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578096000000",
    "number": "1588203830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18643 JONESBORO CT",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550446500",
            "telephone_number": "612-708-9043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18643 JONESBORO CT",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550446500",
            "telephone_number": "612-708-9043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIANA",
        "middle_name": "KIMMJO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-04",
        "last_updated": "2020-01-04",
        "certification_date": "2020-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "S.gracemn@google.com",
            "affiliation": "N",
            "address_1": "18643 Jonesboro Ct",
            "city": "Lakeville",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550446500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John E Laco DPM PA
• Lindsey John, PT, DPT
• Claire Elizabeth Johnson, PA-C
• Janelle Johnson
• Kevin Neil Johnson, PT,ATC
• Sarah Johnson, M.T.
• Xandra Victoria Johnson
• Alexandra Jones
• Iisha Lakeyia Jones
• Grace Anna Joslyn

• Addiction (Substance Use Disorder) Counselor in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.