Active NPI
Kelsey Brooke Johnson, ARNP
- Family Nurse Practitioner
- Red Oak, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A183921
- Practice address
- 1400 Senate Ave Ste 108
Red Oak, IA 51566-1271 - Phone
- (712) 623-7000
- NPI assigned
- Apr 16, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A183921 | IA | Primary |
Addresses
Primary practice location
1400 Senate Ave Ste 108
Red Oak, IA 51566-1271
Mailing address
1400 Senate Ave Ste 108
Red Oak, IA 51566-1271
Phone (712) 623-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250625002741 | IA | Practitioner - Nurse Practitioner | 4688186539 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Montgomery County Memorial Hospital
Practice addresses (Care Compare)
1400 Senate Ave
102 Women'S Health Clinic
Red Oak, IA 51566-1271
Phone (712) 623-6335
202 Central Ave
Villisca, IA 50864-1025
Phone (712) 826-9592
415 Main St
Suite 1
Malvern, IA 51551-8137
Phone (712) 624-6010
Hospital & facility affiliations
- Montgomery County Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A183921 | IA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montgomery County Memorial Hospital | Current | Accepting new patients | |
| Montgomery County Memorial Hospital | Family | Current | Accepting new patients |
| Montgomery County Memorial Hospital | Current | Accepting new patients |
Locations
2301 Eastern Ave
Red Oak, IA 51566
Phone (712) 623-7270
1400 Senate Ave
Ste 103
Red Oak, IA 51566
Phone (712) 623-7240
1400 Senate Ave
Ste 108
Red Oak, IA 51566
Phone (712) 623-7250
1400 Senate Ave
Ste 108103
Red Oak, IA 51566
Phone (712) 623-7280
205 N U Ave
Villisca, IA 50864
Phone (712) 826-4422
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Red Oak, IA
- NPI 1265405310
Family, IA
-
- Community/Retail Pharmacy
- Red Oak, IA
- NPI 1699887547
-
- Rural Health Clinic/Center
- Villisca, IA
- NPI 1417667072
-
- Rural Health Clinic/Center
- Malvern, IA
- NPI 1639768401
-
- Medicare Defined Swing Bed Hospital Unit
- Red Oak, IA
- NPI 1831162023
-
- Rural Health Clinic/Center
- Red Oak, IA
- NPI 1891405452
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744761600000",
"number": "1992591002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 SENATE AVE STE 108",
"city": "RED OAK",
"state": "IA",
"postal_code": "515661271",
"telephone_number": "712-623-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 SENATE AVE STE 108",
"city": "RED OAK",
"state": "IA",
"postal_code": "515661271",
"telephone_number": "712-623-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KELSEY",
"middle_name": "BROOKE",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-16",
"last_updated": "2025-04-16",
"certification_date": "2025-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IA",
"license": "A183921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Red Oak, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.