Kea Johnson

Primary specialty

ContractorTaxonomy code 171W00000X

License

45D2249010 Issued in TX

Practice address

2714 S 2ND Ave
Dallas, TX 75210-2090

Phone

(469) 720-3797

NPI assigned

Jan 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1861144438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2852",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750302852",
            "telephone_number": "469-720-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2714 S 2ND AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752102090",
            "telephone_number": "469-720-3797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "TX",
            "license": "45D2249010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA WAIVER",
            "identifier": "45D2249010",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kari Lynn Johnson, OTR
• Karla Johnson
• Karmen Johnson, RBT
• Katherine Anna Johnson, MD
• Kathryn Margaret Johnson, R.D., L.D.
• Kelly Johnson, PT, DPT
• Kelly A. Johnson, MD
• Kendra Johnson
• Kendrick C Johnson, CRNA
• Kenneth B Johnson, MD

• Contractor in Dallas, TX
• Providers in Dallas, TX by specialty
• Contractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.