Kelley Holt Johnson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5009504 Issued in NC

Practice address

5335 Yadkin Rd
Fayetteville, NC 28303-3254

Phone

(910) 826-7337

Fax

(910) 826-7261

NPI assigned

May 18, 2017

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Generations Family Practice, PA

  • Family Medicine Physician
  • Cary, NC
  • NPI 1407902059
  Medicare reassignment NPD
• Generations Family Practice, PA

  dba Triad Internal Medicine

  • Internal Medicine Physician
  • Asheboro, NC
  • NPI 1043894504
  NPD
• Generations Family Practice, PA

  dba Triad Primary Care

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1285205708
  NPD
• Brick City Primary Care, PLLC

  • Family Medicine Physician
  • Sanford, NC
  • NPI 1003050238
  NPD (past)
• Carolina Family Foot Care PC

  • Podiatric Clinic/Center
  • Fuquay Varina, NC
  • NPI 1831306711
  NPD (past)
• Kidzcare Pediatrics, PC

  • Pediatrics Physician
  • Fayetteville, NC
  • NPI 1164657532
  NPD (past)
• Kidzcare Pediatrics, PC

  • Pediatrics Physician
  • Hope Mills, NC
  • NPI 1679529051
  NPD (past)

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1629505813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5617 RAMSEY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283111423",
            "telephone_number": "910-483-7337",
            "fax_number": "910-483-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5335 YADKIN RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033254",
            "telephone_number": "910-826-7337",
            "fax_number": "910-826-7261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1688 S Horner Blvd",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "NC",
            "postal_code": "273305634",
            "country_code": "US",
            "telephone_number": "919-775-7337",
            "fax_number": "919-775-1525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KELLEY",
        "middle_name": "HOLT",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5009504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Johnson, LCMHCA
• Jerome Johnson
• John Johnson
• Joyce Noel Johnson, LMBT
• Kathleen Cecilia Johnson, PHARMD
• Kiana Johnson
• Lashaundra Johnson
• Laura Johnson
• Laura Pitts Johnson, LCSW
• Lisa S Johnson, DNP, MSN, RN

• Family Nurse Practitioner in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.