Kwenda Kikora Johnson, P.A.
Individual provider Active NPI Medical Physician Assistant · Hapeville, GA
NPI 1801811997 · NPPES record last updated Jan 26, 2026
Key facts
- NPI
- 1801811997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 13575 (GA)
- Practice address
- 535 N Central Ave
Hapeville, GA 30354-1603 - Phone
- (404) 761-4040
- NPI assigned
- Jul 12, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 15
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150731017185 | CA | Practitioner - Physician Assistant | 4082613617 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13575 | GA | MD | Specialist |
| 00351 | NC | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Feather River Tribal Health Inc | Current |
Accepting new patients | |
| Cep America - Auc PC | Current |
Accepting new patients | |
| Open Door Community Health Centers | Current |
Accepting new patients | |
| Community Medical Centers, Inc | Current |
Accepting new patients | |
| Community Medical Centers Inc | Current |
Accepting new patients | |
| Carolinas Physicians Network Inc | Past | Accepting new patients | |
| Carolinas Physicians Network Inc | Past | Accepting new patients | |
| Carolinas Physicians Network Inc | Past | Accepting new patients | |
| Union Urgent Care LLC | Past | Accepting new patients | |
| Union Urgent Care LLC | Past | Accepting new patients | |
| Carolinas Physicians Network Inc | Past | Accepting new patients | |
| Carolinas Physicians Network Inc | Past | Accepting new patients |
Locations
1275 8th St
Arcata, CA 95521
2200 Tydd St
Eureka, CA 95501
Phone (707) 269-7051
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
2145 5th Ave
Oroville, CA 95965
Phone (530) 534-3793
7210 Murray Dr
Stockton, CA 95210
Phone (209) 373-2816
730 N Central Ave
Tracy, CA 95376
Phone (209) 820-1500
1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545
Interoperability endpoints
- kwenda.johnson.p2@direct.hvvmg.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 13575 | GA | Yes |
Addresses
Primary practice location
535 N Central Ave
Hapeville, GA 30354-1603
Mailing address
5753 Jubilant Dr
Rex, GA 30273-1574
Phone (707) 656-6326
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801811997 | Other | GA | MEDICINE |
Other providers in Hapeville, GA
- Sharon Howard
- Sarah Howie
- Imc Primera LLC
- Insight Wellness Solutions Inc
- Gregory Jackson
- Sydney Renee Kesler
- Khan Orthopaedics Associate
- Ishtiaq A. Khan
- Kopacetic Khiropractic LLC.
- Shailesh S Kothari
All providers in Hapeville, GA · Medical Physician Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.