Individual provider Active NPI

Kimberly Wan Johnston, CRNP

  • Acute Care Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1730811324
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R228785 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1590
Phone
(410) 328-6110
NPI assigned
Jun 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R228785 MD
Acute Care Nurse Practitioner 363LA2100X R228785 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1590

Mailing address

35 E Wheeling St
Baltimore, MD 21230-4029

Other practice location 1

1800 Orleans St
Baltimore, MD 21287-0010
Phone (410) 955-5000

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20230127000740 MD Practitioner - Nurse Practitioner 4981075033 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

4940 Eastern Ave
Baltimore, MD 21224-2735
Phone (410) 550-0100

5755 Cedar LN
Columbia, MD 21044-2912
Phone (410) 740-7544

5759 Cedar LN
Columbia, MD 21044-2912
Phone (443) 718-3738

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Apr 6, 2023 Accepting new patients
Johns Hopkins University CurrentSince Apr 6, 2023 Accepting new patients
Johns Hopkins University Current Accepting new patients
Shock Trauma Associates, P.a. CurrentSince Oct 19, 2022 Accepting new patients

Locations

4940 Eastern Ave
Baltimore, MD 21224

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

1800 Orleans St
Baltimore, MD 21287
Phone (410) 502-2037

Interoperability endpoints

  • Direct secure messaging: kwan246150@direct.hopkinsmedicine.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1730811324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 E WHEELING ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212304029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011590",
            "telephone_number": "410-328-6110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Orleans St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870010",
            "country_code": "US",
            "telephone_number": "410-955-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "KIMBERLY",
        "middle_name": "WAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R228785",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R228785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.