Individual provider Active NPI

Kara E Johnson, M.D.

  • Internal Medicine Physician
  • Prescott Valley, AZ
National Provider Identifier
1942251996
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
29307 Issued in AZ
Practice address
3200 N Windsong Dr
Prescott Valley, AZ 86314-2255
Phone
(928) 772-1505
Fax
(928) 772-6343
NPI assigned
May 15, 2006
Last updated
Aug 22, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 29307 AZ Primary

Addresses

Primary practice location

3200 N Windsong Dr
Prescott Valley, AZ 86314-2255

Mailing address

3200 N Windsong Dr
Prescott Valley, AZ 86314-2255
Phone (928) 772-1505

Other identifiers 1

IdentifierTypeStateIssuer
596413MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20050518001289 AZ Practitioner - Internal Medicine 2860433943 Practice locations: Prescott, AZ

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29307AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Embry Riddle Wellness Center Past Accepting new patients
Adult Residential Care Services, Inc. Past Accepting new patients
Embry-Riddle Aeronautical University, Inc. Past Accepting new patients
Adult Residential Care Services, Inc. Past Accepting new patients

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, 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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187740800000",
    "number": "1942251996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 N WINDSONG DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142255",
            "telephone_number": "928-772-1505",
            "fax_number": "928-772-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 N WINDSONG DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142255",
            "telephone_number": "928-772-1505",
            "fax_number": "928-772-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KARA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "29307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "596413",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

Verify at the official NPI Registry.