Kimberli S Johnston, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9117536 Issued in FL

Practice address

3730 7TH Ter Ste 101
Vero Beach, FL 32960-6556

Phone

(772) 567-2332

Fax

(844) 812-2806

NPI assigned

Feb 15, 2006

Last updated

Sep 12, 2023By 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 2

Addresses

Other identifiers 1

Other names 1

• Kimberli S. Knight Former name

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Florida Cancer Specialists & Research Institute, LLC

  • Medical Oncology Physician
  • Cape Coral, FL
  • NPI 1760590962
  Medicare reassignment NPD

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1932173895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 7TH TER STE 101",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606556",
            "telephone_number": "772-567-2332",
            "fax_number": "844-812-2806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 S Congress Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "FL",
            "postal_code": "334614746",
            "country_code": "US",
            "telephone_number": "561-366-4100",
            "fax_number": "561-439-2717",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1309 N Flagler Dr",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334013406",
            "country_code": "US",
            "telephone_number": "561-366-4100",
            "fax_number": "561-366-4189",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 SE Ocean Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349942236",
            "country_code": "US",
            "telephone_number": "772-287-4061",
            "fax_number": "772-287-4176",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_2": "Division of Neoplastic Diseases",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-0188",
            "fax_number": "414-805-6815",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3401 Pga Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "334102824",
            "country_code": "US",
            "telephone_number": "561-366-4100",
            "fax_number": "561-776-8801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "KIMBERLI",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2023-09-12",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1707",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119014300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLI",
            "last_name": "KNIGHT",
            "middle_name": "S.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mitchell W Johnson, PA
• Ryan Maurice Johnson, MD
• Sherry Danielle Johnson, APRN
• Thomas B Johnson, MD
• Kendra Johnston, MSW
• Adam Robert Jones, DMD MS
• Amanda Paige Jones, PTA
• Andrea Jones, M.D.
• Azat Karen Jones, MA, LMHC, EMDR
• Chaka Jones, MSN, RN

• Physician Assistant in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.