Individual provider Active NPI

Kelly Christina Johnson, M.D.

  • Urology Physician
  • Owings Mills, MD
National Provider Identifier
1871732503
Registry record updated Aug 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
D0076185 Issued in MD
Practice address
21 Crossroads Dr
Suite 200
Owings Mills, MD 21117-5441
Phone
(410) 581-8140
Fax
(410) 356-0885
NPI assigned
Feb 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 25MA08567200 NJ
Urology Physician 208800000X 34470 SC
Urology Physician 208800000X D0076185 MD Primary

Addresses

Primary practice location

21 Crossroads Dr
Suite 200
Owings Mills, MD 21117-5441

Mailing address

25 Crossroads Dr
Suite 306
Owings Mills, MD 21117-5421
Phone (443) 738-2872

Other identifiers 1

IdentifierTypeStateIssuer
254908500MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130726000010 MD Practitioner - Urology 0244495109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chesapeake Urology Associates LLCGroup PAC ID 4789673393, 161 clinicians

Practice addresses (Care Compare)

1838 Greene Tree Rd
Suite 460
Baltimore, MD 21208-7113
Phone (410) 581-8140

201 Plumtree Rd
Suite 210
Bel Air, MD 21015-6053
Phone (410) 803-0089

6535 N Charles St
Suite 625
Baltimore, MD 21204-5835
Phone (410) 825-5454

Hospital & facility affiliations

  • Greater Baltimore Medical Center Hospital, Baltimore, MD, CCN 210044

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0076185MDMDUrology Physician
25MA08567200NJMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Urology Associates, LLC Current Accepting new patients
Chesapeake Urology Associates LLC Urology CurrentSince Jul 1, 2013 Accepting new patients
Chesapeake Urology Associates, LLC Urology Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

21 Crossroads Dr
Ste 200
Owings Mills, MD 21117
Phone (410) 581-8140

25 Crossroads Dr
Ste 306
Owings Mills, MD 21117
Phone (443) 231-1681

1838 Greene Tree Rd
Ste 460
Pikesville, MD 21208
Phone (410) 581-8140

6535 N Charles St
Fl 5
Towson, MD 21204
Phone (410) 825-5454

Interoperability endpoints

  • Direct secure messaging: kellyjohnson@tsicua.allscriptsdirect.net
  • Direct secure messaging: kjohnson129715@direct.umm.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1871732503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CROSSROADS DR",
            "address_2": "SUITE 306",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175421",
            "telephone_number": "443-738-2872",
            "fax_number": "443-738-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CROSSROADS DR",
            "address_2": "SUITE 200",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175441",
            "telephone_number": "410-581-8140",
            "fax_number": "410-356-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KELLY",
        "middle_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-19",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "25MA08567200",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "34470",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MD",
            "license": "D0076185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254908500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

Verify at the official NPI Registry.