Kathleen R Johnson, NP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

53-76727-091 Issued in KS

Practice address

10116 W 105TH St
Overland Park, KS 66212-5746

Phone

(913) 541-0510

Fax

(913) 541-1852

NPI assigned

Oct 17, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

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

Specialty

Nurse Practitioner

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shawnee Mission Medical Center IncGroup PAC ID 9537119037, 282 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Shawnee Mission Hospital, Shawnee Mission, KS, CCN 170104

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.

• Shawnee Mission Medical Center Inc

  • Family Medicine Physician
  • Merriam, KS
  • NPI 1992735690
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Shawnee Mission Medical Center Inc

  • General Acute Care Hospital
  • Merriam, KS
  • NPI 1023171634
  Care Compare affiliation
• Shawnee Mission Medical Center Inc

  • Clinical Medical Laboratory
  • Merriam, KS
  • NPI 1235792003

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1381968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1700214392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10116 W 105TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662125746",
            "telephone_number": "913-541-0510",
            "fax_number": "913-541-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10116 W 105TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662125746",
            "telephone_number": "913-541-0510",
            "fax_number": "913-541-1852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHLEEN",
        "middle_name": "R",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-17",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2023043769",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KS",
            "license": "53-76727-091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillane Mulvey Johnson, PA
• Judith M Johnson, MSN, APRN, BC
• Julie Ann Johnson, LSCSW
• Julie Lynn Johnson, SLP-CFY
• Katherine Joann Johnson, APRN
• Kathryn Ann Johnson, M.A., CCC-SLP
• Kathryn Ann Johnson, OTR/L
• Katie Lynn Johnson, LPC
• Kellie Lucille Johnson, PT, DPT
• Kirk Charles Johnson, D.C.

• Gerontology Nurse Practitioner in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Gerontology Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.
• 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.