Kenneth Eugene Johnson Jr., D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

OS0007290 Issued in FL

Practice address

3200 S University Dr
Davie, FL 33328-2018

Phone

(954) 262-1142

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

Yes

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 FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Nova Southeastern University, Inc

  • Optometrist
  • Ft. Lauderdale, FL
  • NPI 1700924511
  Medicare reassignment NPD
• Nova Southeastern University Inc.

  • Clinical Medical Laboratory
  • Ft. Lauderdale, FL
  • NPI 1770533390
  NPD
• Nova Southeastern University, Inc

  • General Practice Dentistry
  • Davie, FL
  • NPI 1033357611
  NPD
• Nova Southeastern University, Inc

  • Family Medicine Physician
  • Davie, FL
  • NPI 1447345517

  Obstetrics & Gynecology

  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760597009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 SW 20TH ST",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333175226",
            "telephone_number": "954-584-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KENNETH",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "OS0007290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doreen Johnson
• Elizabeth Rodriguez Johnson, LMFT
• Jasmine Denise Johnson
• Jeana Johnson
• Katherine Johnson
• Noelle Johnson, RDN
• Quishawna Johnson
• Terra Johnson
• Alison Fiford Johnston, LCSW,ACSW
• Marlo Jolley, COTA

• Obstetrics & Gynecology Physician in Davie, FL
• Providers in Davie, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.