Organization Active NPI

Knockout Anesthesia

Doing business as Kenneth Andrew Johnson MD

  • Anesthesiology Physician
  • Anaheim, CA
National Provider Identifier
1942435029
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A65948 Issued in CA
Legal business name
KNOCKOUT ANESTHESIA
Doing business as
Kenneth Andrew Johnson MD
Practice address
1211 W la Palma Ave Ste 301
Anaheim, CA 92801-2811
Phone
(714) 284-0737
NPI assigned
May 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Authorized official

Name
Dr. Kenneth Andrew Johnson, MDNPI 1851404263
Title
Owner
Phone
(949) 436-3211

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X A65948 CA Primary

Addresses

Primary practice location

1211 W la Palma Ave Ste 301
Anaheim, CA 92801-2811

Mailing address

PO Box 5486
Orange, CA 92863-5486
Phone (818) 550-0900

Other names 1

  • Kenneth Andrew Johnson MD Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121011000606 CA Part B Supplier - Clinic/Group Practice 7214100577 Receives reassigned benefits from 1 practitioner
Practice locations: Anaheim, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1942435029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5486",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928635486",
            "telephone_number": "818-550-0900",
            "fax_number": "505-293-1524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE STE 301",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012811",
            "telephone_number": "714-284-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOCKOUT ANESTHESIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-19",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-436-3211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A65948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kenneth Andrew Johnson MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.