Kim David Johnson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

19257 Issued in AZ

Practice address

4840 E Indian School Rd
Ste. 101
Phoenix, AZ 85018-5500

Phone

(602) 224-1900

Fax

(602) 224-9444

NPI assigned

Oct 18, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 27, 2019 through Jun 27, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Biltmore Family Physicians, PC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1811078843
  Authorized official Same address or phone
• Mydockj

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1407129646
  NPD (past) Authorized official
• Phoenician Hospice LLC

  • Community Based Hospice Care Agency
  • Scottsdale, AZ
  • NPI 1730624461
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902987936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 E INDIAN SCHOOL RD",
            "address_2": "STE. 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850185500",
            "telephone_number": "602-224-1900",
            "fax_number": "602-224-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 E INDIAN SCHOOL RD",
            "address_2": "STE. 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850185500",
            "telephone_number": "602-224-1900",
            "fax_number": "602-224-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIM",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "19257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Johnson, M.S. OTR/L
• Kathleen R. Johnson
• Kayla R Johnson, LCSW
• Kelsey M Johnson
• Kevin R Johnson, DO
• Kimberly A Johnson, RPH
• Kimberly M Johnson, COTA/L
• Kraymer E Johnson, LPC
• Kristi L Johnson, PHARMD
• Kristopher Johnson

• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.