NPIMap

Individual provider Active NPI

Kevin Michael Johnson, FNP

  • Family Nurse Practitioner
  • Watersmeet, MI
National Provider Identifier
1952961567
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F06190459 Issued in MI
Practice address
N5241 US Highway 45
Watersmeet, MI 49969-0009
Phone
(906) 358-4588
Fax
(906) 358-4118
NPI assigned
Jun 17, 2019
Last updated
Jan 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F06190459 MI Primary

Addresses

Primary practice location

N5241 US Highway 45
Watersmeet, MI 49969-0009

Mailing address

47307 Larson Rd
Atlantic Mine, MI 49905-9203
Phone (906) 281-2186

Other practice location 1

921 W Sharon Ave
Houghton, MI 49931-1921
Phone (906) 483-1777

Other practice location 2

18341 US Highway 41
Lanse, MI 49946-8024
Phone (906) 524-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191029003560 MI Practitioner - Nurse Practitioner 6002148772 Reassigns benefits to 3 organizations
I20250425000115 TX Practitioner - Nurse Practitioner 6002148772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portage Physician Practices IncGroup PAC ID 6103053509, shared by 3 NPIs, 56 clinicians
Lac Vieux Desert Band of Lake Superior Chippewa IndiansGroup PAC ID 2567629181, 16 clinicians

Practice addresses (Care Compare)

500 Campus Dr
Hancock, MI 49930-1452

56720 Calumet Ave
Calumet, MI 49913-1967
Phone (906) 481-8952

56720 Calumet Ave
Suite B
Calumet, MI 49913-1905
Phone (906) 481-8952

921 W Sharon Ave
Houghton, MI 49931-1921
Phone (906) 483-1777

N5241 US Hwy
Watersmeet, MI 49969-0009
Phone (906) 358-4588

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F06190459MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lac Vieux Desert Band of Lake Superior Chippewa Indians CurrentSince Feb 7, 2025 Accepting new patients
Portage Physician Practices Inc CurrentSince Nov 30, 2019 Accepting new patients
Portage Physician Practices Inc Current Accepting new patients
Baraga County Memorial Hospital Current Accepting new patients
Baraga County Memorial Hospital Current Accepting new patients
Portage Physician Practices Inc. CurrentSince Nov 30, 2019 Accepting new patients
Baraga County Memorial Hospital CurrentSince Oct 1, 2019 Accepting new patients
Baraga County Memorial Hospital CurrentSince Oct 1, 2019 Accepting new patients

Locations

500 Campus Dr
Hancock, MI 49930
Phone (906) 483-1000

500 Campus Dr
Ste 5
Hancock, MI 49930
Phone (906) 483-1700

921 W Sharon Ave
Houghton, MI 49931
Phone (906) 483-1777

18341 US Highway 41
Lanse, MI 49946
Phone (906) 524-3300

N5241 US Highway 45
Watersmeet, MI 49969
Phone (906) 358-4587

Interoperability endpoints

  • Direct secure messaging: kevin.johnson.1@8233.direct.athenahealth.com

Organizations & group practices 8

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.

Hospital & facility affiliations 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1952961567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47307 LARSON RD",
            "city": "ATLANTIC MINE",
            "state": "MI",
            "postal_code": "499059203",
            "telephone_number": "906-281-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N5241 US HIGHWAY 45",
            "city": "WATERSMEET",
            "state": "MI",
            "postal_code": "499690009",
            "telephone_number": "906-358-4588",
            "fax_number": "906-358-4118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "921 W Sharon Ave",
            "address_purpose": "LOCATION",
            "city": "Houghton",
            "state": "MI",
            "postal_code": "499311921",
            "country_code": "US",
            "telephone_number": "906-483-1777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18341 US Highway 41",
            "address_purpose": "LOCATION",
            "city": "Lanse",
            "state": "MI",
            "postal_code": "499468024",
            "country_code": "US",
            "telephone_number": "906-524-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "F06190459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watersmeet, MI

Sources for this page

Verify at the official NPI Registry.