Individual provider Active NPI

Kristy Johnson, D.C.

  • Chiropractor
  • Campbell, CA
National Provider Identifier
1841544996
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
32412 Issued in CA
Practice address
621 E Campbell Ave Ste 10B
Campbell, CA 95008-2134
Phone
(408) 915-0012
NPI assigned
Oct 27, 2012
Last updated
Oct 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 32412 CA Primary

Addresses

Primary practice location

621 E Campbell Ave Ste 10B
Campbell, CA 95008-2134

Mailing address

621 E Campbell Ave Ste 10B
Campbell, CA 95008-2134
Phone (408) 915-0012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190605000719 CA Practitioner - Chiropractic 9133452261 Practice locations: Campbell, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

621 E Campbell Ave
Suite 10B
Campbell, CA 95008-2134
Phone (408) 915-0012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32412CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
New Element Chiropractic PastSince Jan 19, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1351296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1841544996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 E CAMPBELL AVE STE 10B",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950082134",
            "telephone_number": "408-915-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 E CAMPBELL AVE STE 10B",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950082134",
            "telephone_number": "408-915-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KRISTY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-27",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "32412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.