KEVIN JOHNSON (NPI# 1396155511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396155511 |
| Entity Type | Individual |
| Full Name | KEVIN JOHNSON |
| Practice Address |
475 Irving Ave Ste 418 Syracuse NY 13210-1573 |
| Mailing Address |
1001 W Fayette St Ste 400 Syracuse NY 13204-2866 |
| Practice Telephone | 3152185303 |
| Mailing Telephone | 9373433315 |
| Mailing Fax Number | 3159373833 |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2019-09-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
294176 | NY | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
294176 | NY | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912463704 | Kevin Johnson | Chiropractor | 2601 E Chapman Ave Ste 214, Fullerton, CA 92831-3737 | 2019-02-16 |
| 1558834234 | Kevin Timothy Johnson | Physician Assistant | 411 Naylor Mill Rd, Salisbury, MD 21801-1191 | 2019-01-06 |
| 1790283588 | Kevin Johnson | Case Manager/Care Coordinator | 201 W. Springfield Ave, Knoxville, TN 37917 | 2018-01-26 |
| 1205384955 | Kevin Johnson Jr. | Community Health Worker | 1261 Roslyn Ave, Akron, OH 44320-3424 | 2016-09-12 |
| 1073949400 | Kevin William Johnson | Counselor | 1147 16th St N, St Petersburg, FL 33705-1104 | 2013-09-17 |
| 1669752200 | Kevin L Johnson | Pharmacist | 2600 S 48th St, Lincoln, NE 68506-2502 | 2011-08-26 |
| 1346536463 | Kevin Charles Johnson | Pharmacist | 747 Highway 259 North, Kilgore, TX 75662-5175 | 2011-06-27 |
| 1770806374 | Kevin Neil Johnson | Physical Medicine & Rehabilitation | 9913 214th St W Ste B, Lakeville, MN 55044-1914 | 2010-03-10 |
| 1326280991 | Kevin Anthony Johnson | Family Medicine | 1400 Hancock Blvd, #1208, Daytona Beach, FL 32114 | 2009-03-29 |
| 1558566588 | Kevin Charles Johnson | Speech-Language Pathologist | 8620 Holly Dr, Suite 230, Everett, WA 98208-1825 | 2007-06-19 |
| Street Address |
475 IRVING AVE STE 418 |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13210-1573 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770586653 | David S Moorthi | Physical Medicine & Rehabilitation | 475 Irving Ave Ste 418, Syracuse, NY 13210-1573 | 2005-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558973586 | Maizie Marie Shaw | Social Worker | 660 Madison Street, Syracuse, NY 13210 | 2020-08-20 |
| 1427666916 | Christine Marie Welker | Registered Nurse | 735 Irving Avenue, Syracuse, NY 13210 | 2020-07-21 |
| 1386263994 | Ashwini Krishna Ashwath | Student in an Organized Health Care Education/Training Program | 750 E. Adams Street, Syracuse, Ny 13210, Syracuse, NY 13210 | 2020-04-14 |
| 1073142329 | Kamala Ojha | Student in an Organized Health Care Education/Training Program | 750-east Adam's Street, Syracuse, NY 13210 | 2020-04-07 |
| 1003442369 | Brittany Nicole Lippert | Counselor | 615 Madison St, Syracuse, NY 13210 | 2020-03-19 |
| 1902430499 | Dkt Physician Pllc | Internal Medicine | 475 Irving Ave, Suite 410, Syracuse, NY 13210 | 2020-02-24 |
| 1376194720 | Sarah Van Eenenaam | Physician Assistant | Adult Cardiac Surgery, 750 East Adams St, Syracuse, NY 13210 | 2019-09-26 |
| 1265099022 | Michelle Gallagher | Psychologist | Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210 | 2019-05-28 |
| 1639659428 | Francesca Wanda Cotrupe | Physical Medicine & Rehabilitation | Upstate Medical University Hospital, 750 E Adams Street, Syracuse, NY 13210 | 2018-08-21 |
| 1700370327 | Dallin Lindahl | Physical Medicine & Rehabilitation | 750 E Adams St # Jh308, Syracuse, NY 13210 | 2018-06-18 |
| Find all providers in zip 13210 | ||||
| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235165341 | Steven Batki | Psychiatry & Neurology | 750 E Adams St, Syracuse, NY 13210-2306 | 2006-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083047658 | Stanley Samuel | Psychiatry & Neurology | 2925 West 19th Street, Brooklyn, NY 11224 | 2013-08-18 |
| 1942434311 | Daniel Rollings Karlin | Psychiatry & Neurology | 2061 Narragansett Ave # 2, Bronx, NY 10461-1741 | 2009-05-13 |
| 1689820474 | Timothy Koehler Brennan | Psychiatry & Neurology | 1000 10th Ave Fl 8, New York, NY 10019 | 2008-08-12 |
| 1821295577 | Marianne Elizabeth Chai | Psychiatry & Neurology | 226 E 52nd St, Center for Living, New York, NY 10022-6201 | 2007-06-27 |
| 1538371331 | James Peter Wolberg | Psychiatry & Neurology | 1st Ave & 16th St, Bernstein Pavilion, New York, NY 10003 | 2007-05-04 |
| 1578786141 | Bryan James Mcgreal | Psychiatry & Neurology | 324 Lafayette St Fl 8, New York, NY 10012-2726 | 2007-04-11 |
| 1417070442 | Alejo Parellada | Psychiatry & Neurology | 634 Bergen St, #1, Brooklyn, NY 11238-3450 | 2007-04-06 |
| 1366563652 | Steven Joesph Lee | Psychiatry & Neurology | 130 W. 19th St., Suite Thfb, New York, NY 10011 | 2007-04-03 |
| 1154463511 | Ralph Joseph Carotenuto | Psychiatry & Neurology | 157 South Lake Ave, Albany, NY 12208 | 2007-02-13 |
| 1245383405 | John J Mariani | Psychiatry & Neurology | 51 E 25th St Ste 7e, New York, NY 10010-2945 | 2007-01-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.