Active NPI
Kaila E Johnson
- Registered Dietitian
- Las Vegas, NV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 39024-DI-3
- Practice address
- 3041 E Flamingo Rd
Las Vegas, NV 89121-7446 - Phone
- (239) 284-3220
- NPI assigned
- Feb 3, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dietary Manager | 132700000X | DI61188977 | WA | |
| Registered Dietitian | 133V00000X | L006372 | NC | |
| Registered Dietitian | 133V00000X | 12529665-4901 | UT | |
| Registered Dietitian | 133V00000X | 86010388 | CA | |
| Registered Dietitian | 133V00000X | ND10310 | FL | |
| Registered Dietitian | 133V00000X | 269357 | KY | |
| Registered Dietitian | 133V00000X | 2021019201 | MO | |
| Registered Dietitian | 133V00000X | 10213181 | OR | |
| Registered Dietitian | 133V00000X | DI61188977 | WA | |
| Registered Dietitian | 133V00000X | 39024-DI-3 | NV | Primary |
Addresses
Primary practice location
3041 E Flamingo Rd
Las Vegas, NV 89121-7446
Mailing address
3041 E Flamingo Rd
Las Vegas, NV 89121-7446
Phone (239) 284-3220
Other practice location 1
160 N Eagle Creek Dr Ste 420
Lexington, KY 40509-2125
Phone (502) 305-7614
Other practice location 2
240 N Broadway Ste 208
Portland, OR 97227-1881
Phone (503) 664-9111
Other practice location 3
330 1st Capitol Dr Ste 240
Saint Charles, MO 63301-2846
Phone (314) 900-1112
Other practice location 4
600 Anton Blvd Ste 1100
Costa Mesa, CA 92626-7100
Phone (720) 204-5760
Other practice location 5
5100 NW 33rd Ave Ste 245
Ft Lauderdale, FL 33309-6381
Phone (786) 605-9055
Other practice location 6
3214 Charles B Root Wynd Ste 203
Raleigh, NC 27612-5440
Phone (919) 877-6800
Other practice location 7
159 W Broadway Ste 200
Salt Lake City, UT 84101-1923
Phone (404) 408-5442
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC, MI, CA, AZ, NJ, NY
Enrollment records 6
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220924000377 | NC | Practitioner - Registered Dietitian Or Nutrition Professional | 5294122727 | |
| I20230413000928 | MI | Practitioner - Registered Dietitian Or Nutrition Professional | 5294122727 | |
| I20231004002068 | CA | Practitioner - Registered Dietitian Or Nutrition Professional | 5294122727 | |
| I20250109000203 | AZ | Practitioner - Registered Dietitian Or Nutrition Professional | 5294122727 | |
| I20250110001887 | NJ | Practitioner - Registered Dietitian Or Nutrition Professional | 5294122727 | |
| I20250117000189 | NY | Practitioner - Registered Dietitian Or Nutrition Professional | 5294122727 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI61188977 | WA | MD | Dietary Manager |
| 86010388 | CA | MD | Registered Dietitian |
| ND10310 | FL | MD | Registered Dietitian |
| L006372 | NC | MD | Registered Dietitian |
| 12529665-4901 | UT | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Strive Health Or DS, LLC | Current | Accepting new patients | |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Cloud Health Medical Group, P.a. | Past | Accepting new patients | |
| Strategic Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Locations
1125 17th St
Ste 1000
Denver, CO 80202
Phone (855) 962-4638
1600 Stout St
Ste 2000
Denver, CO 80202
Phone (720) 240-5760
240 N Broadway
Ste 208
Portland, OR 97227
Phone (503) 604-9111
Interoperability endpoints
- kaila.johnson.p3@direct.caremorewest.nextgenshare.com
- strivehealth.kailajohnson@147989.advancedmd-direct.com
- strivehealth.kailajohnson@148422.advancedmd-direct.com
- ssmhealthkidney.kailajohnson@144776.advancedmd-direct.com
Organizations & group practices 5
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.
-
- Nephrology Physician
- Denver, CO
- NPI 1316604184
-
- Internal Medicine Physician
- White Plains, NY
- NPI 1528744935
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675987200000",
"number": "1821456930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3041 E FLAMINGO RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891217446",
"telephone_number": "239-284-3220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3041 E FLAMINGO RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891217446",
"telephone_number": "239-284-3220"
}
],
"practiceLocations": [
{
"address_1": "160 N Eagle Creek Dr Ste 420",
"address_purpose": "LOCATION",
"city": "Lexington",
"state": "KY",
"postal_code": "405092125",
"country_code": "US",
"telephone_number": "502-305-7614",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "240 N Broadway Ste 208",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972271881",
"country_code": "US",
"telephone_number": "503-664-9111",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "330 1st Capitol Dr Ste 240",
"address_purpose": "LOCATION",
"city": "Saint Charles",
"state": "MO",
"postal_code": "633012846",
"country_code": "US",
"telephone_number": "314-900-1112",
"fax_number": "888-920-1915",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "600 Anton Blvd Ste 1100",
"address_purpose": "LOCATION",
"city": "Costa Mesa",
"state": "CA",
"postal_code": "926267100",
"country_code": "US",
"telephone_number": "720-204-5760",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5100 NW 33rd Ave Ste 245",
"address_purpose": "LOCATION",
"city": "Ft Lauderdale",
"state": "FL",
"postal_code": "333096381",
"country_code": "US",
"telephone_number": "786-605-9055",
"fax_number": "913-676-7358",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3214 Charles B Root Wynd Ste 203",
"address_purpose": "LOCATION",
"city": "Raleigh",
"state": "NC",
"postal_code": "276125440",
"country_code": "US",
"telephone_number": "919-877-6800",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "159 W Broadway Ste 200",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841011923",
"country_code": "US",
"telephone_number": "404-408-5442",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "KAILA",
"middle_name": "E",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-03",
"last_updated": "2023-02-10",
"certification_date": "2023-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "132700000X",
"taxonomy_group": "",
"desc": "Dietary Manager",
"state": "WA",
"license": "DI61188977",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L006372",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "UT",
"license": "12529665-4901",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86010388",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND10310",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KY",
"license": "269357",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "2021019201",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "10213181",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "DI61188977",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NV",
"license": "39024-DI-3",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.