Individual provider Active NPI

Kyle Gregory Johnson, APRN FNP-C

  • Family Nurse Practitioner
  • Owensboro, KY
National Provider Identifier
1730954181
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4011302 Issued in KY
Practice address
2211 Mayfair Dr Ste 101
Owensboro, KY 42301-4569
Phone
(270) 688-1352
NPI assigned
Nov 15, 2023
Last updated
Sep 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4011302 KY Primary

Addresses

Primary practice location

2211 Mayfair Dr Ste 101
Owensboro, KY 42301-4569

Mailing address

113 W Broadway St
Princeton, IN 47670-1501
Phone (812) 480-9469

Other practice location 1

2005 N Dixie Hwy
Elizabethtown, KY 42701
Phone (812) 480-9469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240823003473 KY Practitioner - Nurse Practitioner 1951552009 Reassigns benefits to 5 organizations
I20251220000534 NY Practitioner - Nurse Practitioner 1951552009 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Claxton-Hepburn Medical CenterGroup PAC ID 8426966508, 78 clinicians
Carthage Area Hospital IncGroup PAC ID 9931010485, shared by 16 NPIs, 119 clinicians
Delphi Healthcare PLLCGroup PAC ID 9537229661, 68 clinicians
CG Medical Associates IncGroup PAC ID 6608052196, 171 clinicians
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians
Radcliff Urgent Care Clinic LLCGroup PAC ID 2264812510, 5 clinicians

Practice addresses (Care Compare)

100 Horwood PL
Ogdensburg, NY 13669-4510
Phone (315) 394-9462

1001 W St
Carthage, NY 13619-9703
Phone (315) 493-1000

2005 N Dixie Hwy
Elizabethtown, KY 42701
Phone (270) 640-0146

214 King St
Ogdensburg, NY 13669-1142
Phone (315) 393-3600

2211 Mayfair Dr
Suite 101
Owensboro, KY 42301-4569
Phone (270) 691-8070

446 Fairview Ave
Suite 200
Hudson, NY 12534-1048
Phone (518) 267-3496

650 W Lincoln Trail Blvd
Radcliff, KY 40160-2679
Phone (270) 352-4601

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Delphi Healthcare PLLC CurrentSince Nov 1, 2025 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group Inc Family CurrentSince Nov 3, 2024 Accepting new patients
Acute Care LLC CurrentSince Oct 1, 2025 Accepting new patients
Radcliff Urgent Care Clinic LLC CurrentSince Jun 21, 2025 Accepting new patients
Wellnow Urgent Care, PC CurrentSince Jan 26, 2026 Accepting new patients
Owensboro Health Medical Group, Inc. Family CurrentSince Nov 3, 2024 Accepting new patients
Green Valley Emergency Physicians, LLC Family CurrentSince Jun 1, 2024 Accepting new patients
CG Medical Associates Inc CurrentSince Jan 17, 2025 Accepting new patients
Claxton-Hepburn Medical Center Past Accepting new patients

Locations

2508 Scottsville Rd
Ste 104
Bowling Green, KY 42104
Phone (270) 746-6330

651 US 31W Byp
Ste 106
Bowling Green, KY 42101
Phone (270) 495-0440

7683 Mall Rd
Unit B
Florence, KY 41042
Phone (859) 817-1320

1324 Carter Rd
Owensboro, KY 42301
Phone (270) 713-4610

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

1530 Lone Oak Rd
Paducah, KY 42003
Phone (270) 444-2444

650 W Lincoln Trail Blvd
Radcliff, KY 40160
Phone (270) 351-3192

1001 West St
Carthage, NY 13619
Phone (315) 493-1000

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

845 Route 5 and 20
Irving, NY 14081
Phone (716) 593-1100

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

214 King St
Ogdensburg, NY 13669
Phone (315) 713-5660

7300 Beechmont Ave
Cincinnati, OH 45230
Phone (513) 232-9100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25653/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 10

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": "1700006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1730954181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 W BROADWAY ST",
            "city": "PRINCETON",
            "state": "IN",
            "postal_code": "476701501",
            "telephone_number": "812-480-9469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 MAYFAIR DR STE 101",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423014569",
            "telephone_number": "270-688-1352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2005 N Dixie Hwy",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "KY",
            "postal_code": "42701",
            "country_code": "US",
            "telephone_number": "812-480-9469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KYLE",
        "middle_name": "GREGORY",
        "credential": "APRN FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-15",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4011302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.