Kody Johnson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2021021292 Issued in MO

Practice address

1604 C. North Main St
Mountain Grove, MO 65704-6570

Phone

(417) 926-1713

NPI assigned

Jul 15, 2021

Last updated

Jul 15, 2021By the provider in NPPES

Sex

Male

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

Enrolled in MO

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

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Douglas County Public Health Services Group, Inc.Group PAC ID 3072423052, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Douglas County Public Health Services Group, Inc.

  dba Missouri Ozarks Community Health

  • Federally Qualified Health Center (FQHC)
  • Mansfield, MO
  • NPI 1912904004
  Medicare reassignment Care Compare group
• Douglas County Public Health Services Group, Inc.

  dba Missouri Ozarks Community Health

  • Federally Qualified Health Center (FQHC)
  • Gainesville, MO
  • NPI 1598762593
  NPD (past)
• Douglas County Public Health Services Group, Inc.

  • Public Health Dentistry
  • Ava, MO
  • NPI 1942785399
  NPD (past)
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1710559018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1359",
            "city": "AVA",
            "state": "MO",
            "postal_code": "656081359",
            "telephone_number": "417-683-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 C. NORTH MAIN ST",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657046570",
            "telephone_number": "417-926-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KODY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021021292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Haynie
• Abigail Dawn Hempel, ATC
• Tammy Joetta Higgins
• Elton W. Hoerning, MD
• Jody L Jarrett, LPC
• Mary Johnson, NP
• Alisha K. Jones, FNP
• Katie D. Peterson, DDS, PC
• Jessica Renee King, MD
• Lorraine Kusior, LPC, NCC

• Family Nurse Practitioner in Mountain Grove, MO
• Providers in Mountain Grove, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.