Individual provider Active NPI

Johnna L Kohl, M.D

  • General Practice Physician
  • Anchorage, AK
National Provider Identifier
1659345171
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
4771 Issued in AK
Practice address
4001 Dale St
Ste 210
Anchorage, AK 99508
Phone
(907) 929-5888
Fax
(907) 929-5886
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 4771 AK Primary

Addresses

Primary practice location

4001 Dale St
Ste 210
Anchorage, AK 99508

Mailing address

4001 Dale Street Ste 210
Anchorage, AK 99508
Phone (907) 929-5888

Other identifiers 1

IdentifierTypeStateIssuer
MD44124MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150527001374 AK Practitioner - Family Practice 6204913601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arizona College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Anchorage Bariatrics, LLCGroup PAC ID 0042505018, 20 clinicians

Practice addresses (Care Compare)

3909 Arctic Blvd
Suite 101
Anchorage, AK 99503-5769
Phone (907) 770-2380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4771AKMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anchorage Bariatrics, LLC CurrentSince Jun 8, 2021 Accepting new patients
First Care Medical Centers LLC Past Accepting new patients
Alaska Medical Clinics, LLC Past Accepting new patients

Locations

3909 Arctic Blvd
Ste 101
Anchorage, AK 99503
Phone (907) 272-1275

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15729/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1659345171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 DALE STREET STE 210",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99508",
            "telephone_number": "907-929-5888",
            "fax_number": "907-929-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 DALE ST",
            "address_2": "STE 210",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99508",
            "telephone_number": "907-929-5888",
            "fax_number": "907-929-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHL",
        "first_name": "JOHNNA",
        "middle_name": "L",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AK",
            "license": "4771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD44124",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.