Kiesha Charis Johnson

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-13367 Issued in NC

Practice address

2314 Nation Ave Apt 4
Durham, NC 27707-2015

Phone

(973) 489-1294

NPI assigned

Aug 29, 2022

Last updated

Mar 12, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA, NC2 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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Johnston Health Hospital, Smithfield, NC, CCN 340090
• Rex Hospital Hospital, Raleigh, NC, CCN 340114

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kjohnson1233854@direct.unc.nchie.net

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.

• North Carolina MG, LLC

  dba UNC Health North Carolina Heart and Vascular

  • Hospitalist Physician
  • Raleigh, NC
  • NPI 1215741640
  Medicare reassignment Care Compare group
• Albany Area Primary Health Care, Inc.

  dba East Albany Medical Center

  • Federally Qualified Health Center (FQHC)
  • Albany, GA
  • NPI 1780608992
  Medicare reassignment
• Albany Area Primary Health Care, Inc

  dba Radium Springs Middle School-Based Health Center

  • Federally Qualified Health Center (FQHC)
  • Albany, GA
  • NPI 1013709625
  NPD
• Albany Area Primary Health Care, Inc.

  dba AAPHC Northwest Family Medical and Dental Center

  • Federally Qualified Health Center (FQHC)
  • Albany, GA
  • NPI 1700360435
  NPD
• Rex Hospital Inc

  dba North Carolina Heart and Vascular

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1972939643
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Johnston Health Services Corporation

  dba Johnston Health

  • General Acute Care Hospital
  • Smithfield, NC
  • NPI 1619911104
  Care Compare affiliation
• Rex Hospital Inc.

  dba Rex Hospital

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1497797088
  Care Compare affiliation

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1821718057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 NATION AVE APT 4",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072015",
            "telephone_number": "973-489-1294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 NATION AVE APT 4",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072015",
            "telephone_number": "973-489-1294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "509 N Brightleaf Blvd",
            "address_purpose": "LOCATION",
            "city": "Smithfield",
            "state": "NC",
            "postal_code": "275774407",
            "country_code": "US",
            "telephone_number": "919-938-7189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIESHA",
        "middle_name": "CHARIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13367",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjohnson1233854@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "509 N Brightleaf Blvd",
            "city": "Smithfield",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275774407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine J Johnson, L.C.S.W
• Kathryn Mary Cervino Johnson, AGACNP-BC
• Kellie Berne Johnson, LCSW
• Kelly Colleen Johnson, LCSW
• Kendra Johnson
• Kim A. Johnson, R.D., L.D.N.
• Kim Graham Johnson, M.D.
• Kimberly Johnson, M.D.
• Kimberly Renee Johnson, MSW, P-LCSW
• Krystal Brown Johnson, M.D.

• Physician Assistant in Durham, NC
• Providers in Durham, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.