Kevin R. Johnson, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

18376 Issued in MS

Practice address

2402 5TH St N
Columbus, MS 39705-2000

Phone

(662) 690-8007

Fax

(662) 842-4653

NPI assigned

Mar 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Family Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Mississippi Medical Clinics IncGroup PAC ID 6103736665, 120 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevinjohnson@nmhs.medalliesdirect.net

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.

• North Mississippi Medical Clinics Inc

  • Internal Medicine Physician
  • Tupelo, MS
  • NPI 1053469486

  Family Medicine, MS

  Medicare reassignment Care Compare group NPD
• North Mississippi Medical Center

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1376969683
  NPD
• North Mississippi Medical Clinics Inc

  • Obstetrics & Gynecology Physician
  • West Point, MS
  • NPI 1588769970
  NPD
• North Ms Emergency Physicians

  • Emergency Medicine Physician
  • Tupelo, MS
  • NPI 1891724035
  NPD (past)

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

• North Mississippi Medical Center, Inc.

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1598875460

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1992773535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405827",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303845827",
            "telephone_number": "870-934-5821",
            "fax_number": "870-934-5384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 5TH ST N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052000",
            "telephone_number": "662-690-8007",
            "fax_number": "662-842-4653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KEVIN",
        "middle_name": "R.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "18376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06202721",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Russell, III, D.M.D., PA
• Quenae Johnson-Byrd
• April Johnson
• Brandon Johnson, ATC
• Emma Johnson, PTA
• Matthew Johnson
• Monica Louise Johnson
• Samuel A Johnson, MD
• Trecia Sue Johnson, DC
• Troy Neal Johnson

• All providers in Columbus, MS
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; 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.

Verify at the official NPI Registry.