Individual provider Active NPI

Kaila E Johnson

  • Registered Dietitian
  • Las Vegas, NV
National Provider Identifier
1821456930
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
39024-DI-3 Issued in NV
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

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
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, NY6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
DI61188977WAMDDietary Manager
86010388CAMDRegistered Dietitian
ND10310FLMDRegistered Dietitian
L006372NCMDRegistered Dietitian
12529665-4901UTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Strive Health Or DS, LLC CurrentSince Aug 17, 2025 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 PastSince Jun 7, 2025 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

  • Direct secure messaging: kaila.johnson.p3@direct.caremorewest.nextgenshare.com
  • Direct secure messaging: strivehealth.kailajohnson@147989.advancedmd-direct.com
  • Direct secure messaging: strivehealth.kailajohnson@148422.advancedmd-direct.com
  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.