Individual provider Active NPI

Kory Johnson, D.C.

  • Chiropractor
  • Pensacola, FL
National Provider Identifier
1720490865
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12344 Issued in FL
Practice address
8124 Pensacola Blvd
Pensacola, FL 32534-4354
Phone
(417) 234-7861
NPI assigned
May 23, 2014
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2014015304 MO
Chiropractor 111N00000X 1352 HI
Chiropractor 111N00000X CH12344 FL Primary

Addresses

Primary practice location

8124 Pensacola Blvd
Pensacola, FL 32534-4354

Mailing address

8124 Pensacola Blvd
Pensacola, FL 32534-4354
Phone (417) 234-7861

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231127001472 FL Practitioner - Chiropractic 9032438809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edge Family Chiropractic PAGroup PAC ID 2365572310, 2 clinicians

Practice addresses (Care Compare)

8124 Pensacola Blvd
Pensacola, FL 32534-4354
Phone (850) 476-7117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH12344FLMDChiropractor
1352HIMDChiropractor
2014015304MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Edge Family Chiropractic, P.a. Chiropractor CurrentSince Aug 5, 2025 Accepting new patients
Red Valley Chiropractic and Massage Inc Chiropractor PastSince Jul 24, 2022 Accepting new patients

Locations

8124 Pensacola Blvd
Pensacola, FL 32534
Phone (850) 476-7117

Organizations & group practices 2

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": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1720490865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8124 PENSACOLA BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325344354",
            "telephone_number": "417-234-7861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8124 PENSACOLA BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325344354",
            "telephone_number": "417-234-7861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KORY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-23",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2014015304",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "HI",
            "license": "1352",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; 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.