Kristen Elizabeth Johnston, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

License

1700469095 Issued in CA

Practice address

5502 Marvin Shields Blvd
Gulfport, MS 39501

Phone

(228) 822-5922

NPI assigned

May 4, 2021

Last updated

Dec 2, 2022By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1700469095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 BRENTWOOD BLVD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034026",
            "telephone_number": "619-952-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5502 MARVIN SHIELDS BLVD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39501",
            "telephone_number": "228-822-5922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34800 Bob Wilson Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921341098",
            "country_code": "US",
            "telephone_number": "619-532-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "KRISTEN",
        "middle_name": "ELIZABETH",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2022-12-02",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "CA",
            "license": "1700469095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Elizabeth Johnson, MS
• Laurie B Johnson, SLP
• Quentella Johnson
• William Chase Johnson, MD
• David N Johnston Jr., CRNA
• Michelle L Johnston, MS, CCC/SLP
• Jolyn Therapy Services LLC
• Jones Coaching and Counseling
• Jones County Medical Supplies, Inc (Gulf Coast Medical Supply)
• Adrianne Jones

• Independent Duty Corpsman in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Independent Duty Corpsman in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.