Individual provider Active NPI

Kody R Johnson, D.C.

  • Chiropractor
  • Columbia, MO
National Provider Identifier
1700061967
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2007034175 Issued in MO
Practice address
2011 Chapel Plaza CT
Suite 111
Columbia, MO 65203-6398
Phone
(660) 651-4335
NPI assigned
Jan 7, 2008
Last updated
Jan 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2007034175 MO Primary

Addresses

Primary practice location

2011 Chapel Plaza CT
Suite 111
Columbia, MO 65203-6398

Mailing address

1301 Ashland Rd
Apt. F
Columbia, MO 65201-5387
Phone (660) 651-4335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080213000084 MO Practitioner - Chiropractic 8426131509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

908 Rain Forest Pkwy
Suite B
Columbia, MO 65202-1657
Phone (573) 447-0841

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hanft Family Chiropractic, Inc. Chiropractor CurrentSince Aug 15, 2015 Accepting new patients
Johnson Chiropractic & Holistic Health Center, LLC Chiropractor CurrentSince Aug 15, 2015 Accepting new patients
Elizabeth Hagan Chiropractic LLC Chiropractor Past Accepting new patients

Locations

1109 Club Village Dr
Ste 104
Columbia, MO 65203
Phone (573) 447-0841

908 Rain Forest Pkwy
Ste B
Columbia, MO 65202
Phone (573) 447-0841

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1700061967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 ASHLAND RD",
            "address_2": "APT. F",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015387",
            "telephone_number": "660-651-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 CHAPEL PLAZA CT",
            "address_2": "SUITE 111",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652036398",
            "telephone_number": "660-651-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KODY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2007034175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.

Verify at the official NPI Registry.