Kyle Allen Johnson, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024185091 Issued in VA

Practice address

30 Technology Dr
Rocky Mount, VA 24151-3008

Phone

(540) 483-0582

NPI assigned

Sep 6, 2022

Sex

Male

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Piedmont Regional Community Services Board

  • Community/Behavioral Health Agency
  • Martinsville, VA
  • NPI 1699754010
  Medicare reassignment NPD

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1649991944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 TECHNOLOGY DR",
            "city": "ROCKY MOUNT",
            "state": "VA",
            "postal_code": "241513008",
            "telephone_number": "540-483-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 TECHNOLOGY DR",
            "city": "ROCKY MOUNT",
            "state": "VA",
            "postal_code": "241513008",
            "telephone_number": "540-483-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KYLE",
        "middle_name": "ALLEN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024185091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irby Dentistry - Rocky Mount, P.C.
• Henry Ivey, MD
• James W Willis X DDS PLC (Rocky Mount Family Dentistry)
• David Jensen
• Michael Patrick Jeremiah, MD
• Rhonda Gail Johnson, NP
• Brittany Jones
• Patricia Jones
• Susan Carr Jones, MA
• Journey Thru Counseling & Wellness, LLC (Journey thru Counseling & Wellness)

• Psychiatric/Mental Health Nurse Practitioner in Rocky Mount, VA
• Providers in Rocky Mount, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.