Kelly Marie Johnston, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND8921 Issued in FL

Practice address

22484 NW 87TH Avenue Rd
Micanopy, FL 32667-7435

Phone

(970) 581-5173

NPI assigned

Nov 26, 2025

Last updated

Nov 26, 2025By 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": "1764115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1700748977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22484 NW 87TH AVENUE RD",
            "city": "MICANOPY",
            "state": "FL",
            "postal_code": "326677435",
            "telephone_number": "970-581-5173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22484 NW 87TH AVENUE RD",
            "city": "MICANOPY",
            "state": "FL",
            "postal_code": "326677435",
            "telephone_number": "970-581-5173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-26",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND8921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Broas, LMT
• Florida Good Health PLLC (Micanopy Health & Wellness)
• Sherry T. Gliesche, MA,MS, CCC/SLP
• Paula Goldberg, AP
• Lisa Hager
• Eric Lanham
• Anna Belen Larson, LM, CPM
• McIntosh Assisted Living
• Mallory Leblanc Pfaffly, MD
• Caroline Roach, LCSW

• Registered Dietitian in Micanopy, FL
• Providers in Micanopy, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2025; 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.