DR. KENDRICK O JOHNSON (NPI# 1558700054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558700054 |
| Entity Type | Individual |
| Full Name | DR. KENDRICK O JOHNSON |
| Credential | D.O. |
| Practice Address |
2000 W Bethany Home Rd Phoenix AZ 85015-2443 |
| Mailing Address |
8514 W Deer Valley Rd Ste 105 Peoria AZ 85382 |
| Practice Telephone | 6022490212 |
| Mailing Telephone | 6232268825 |
| Mailing Fax Number | 6232268835 |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2017-06-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 6702 | AZ | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275971715 | Kendrick C Johnson | Nurse Anesthetist, Certified Registered | 13737 Noel Rd Ste 1400, Dallas, TX 75240-2004 | 2013-06-06 |
| 1790122141 | Kendrick Dewayne Johnson | Neurological Surgery | Osf St Francis Medical Ctr, 530 N.e. Glen Oak Ave, Peoria, IL 61637-0001 | 2013-05-24 |
| 1780720979 | Kendrick Millard Johnson | Emergency Medicine | 1650 Creekside Dr, Folsom, CA 95630-3400 | 2007-01-29 |
| Street Address |
2000 W BETHANY HOME RD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85015-2443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063413524 | Ahmed K Agha | Pharmacist | 2000 W Bethany Home Rd, Phoenix, AZ 85015-2443 | 2005-08-09 |
| 1649897091 | Carolyne N Simiyu Karuku | Registered Nurse | 2000 W Bethany Home Rd, Phoenix, AZ 85015-2443 | 2020-07-01 |
| 1619592490 | Kyndall Elizabeth Cline | Nurse Practitioner | 2000 W Bethany Home Rd, Phoenix, AZ 85015-2443 | 2020-06-08 |
| 1629607924 | Elizabeth Ann Gaddi Nguyen | Student in an Organized Health Care Education/Training Program | 2000 W Bethany Home Rd, Phoenix, AZ 85015-2443 | 2020-04-07 |
| 1104455989 | Ashley Marie Desmarais | Student in an Organized Health Care Education/Training Program | 2000 W Bethany Home Rd, Phoenix, AZ 85015-2443 | 2020-04-03 |
| 1710514963 | Ann Therese Peer | Student in an Organized Health Care Education/Training Program | 2000 W Bethany Home Rd, Phoenix, AZ 85015-2443 | 2020-03-26 |
| 1427685973 | Asta Brianna Jakobsson | Student in an Organized Health Care Education/Training Program | 2000 W Bethany Home Rd, Phoenix, AZ 85015-2443 | 2020-03-25 |
| 1588291298 | Sandra Shi | Student in an Organized Health Care Education/Training Program | 2000 W Bethany Home Rd, Phoenix, AZ 85015-2443 | 2020-03-24 |
| 1881221471 | Louis Justin Needleman | Student in an Organized Health Care Education/Training Program | 2000 W Bethany Home Rd, Phoenix, AZ 85015-2443 | 2020-03-24 |
| 1659914018 | Interventional Neurology of Az LLC | Psychiatry & Neurology | 2000 W Bethany Home Rd, Phoenix, AZ 85015-2443 | 2019-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922610310 | Leticia Karina Maria Lelli | Student in an Organized Health Care Education/Training Program | 4760 N. 20th Ave, Phx, AZ 85015 | 2020-08-18 |
| 1083100564 | Leen Qutachi | Dentist | 1703 W Bethany Home Rd Ste C1, Phoenix, AZ 85015 | 2018-07-08 |
| 1851820146 | Jeff Biever | Spec/Tech, Cardiovascular | 1517 West Lamar Rd, Phoenix, AZ 85015 | 2017-06-08 |
| 1407230964 | Sean Noonan | Optometrist | 1703 W Bethany Home Rd Ste C3, Phoenix, AZ 85015 | 2015-07-15 |
| 1295141620 | Yehia Saleh | Pharmacist | 4040 North 19th Avenue, Cvs Pharmacy, Phoenix, AZ 85015 | 2014-07-07 |
| 1295160380 | Journey To Prosperity | Custodial Care Facility | 1623 W Denton, Phoenix, AZ 85015 | 2013-09-07 |
| 1124372099 | Facing The Future With Hope | Counselor | 5656 N 17th Ave #c7, Phoenix, AZ 85015 | 2012-10-31 |
| 1700133998 | Srujal Vinubhai Patel | Internal Medicine | 6036 N 19th Ave Ste 312, Phoenix, AZ 85015 | 2012-08-07 |
| 1689933947 | Modern Dental Professionals - Arizona PC | Dentist | 2131 E Camelback Road, Ste 102, Phoenix, AZ 85015 | 2012-05-08 |
| 1528360674 | Fatima Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 2025 W Indian School Road, #705, Phoenix, AZ 85015 | 2010-11-23 |
| Find all providers in zip 85015 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339200 | Madison Le | Family Medicine | 3037 W Cat Balue Dr, Phoenix, AZ 85027-2342 | 2020-09-04 |
| 1720604069 | Good Health Medical, PC | Family Medicine | 2632 S 83rd Ave Ste 113, Phoenix, AZ 85043-7206 | 2020-06-23 |
| 1427670751 | Florence Wellness Pllc | Family Medicine | 101 E Washington St Fl 7, Phoenix, AZ 85004-2450 | 2020-05-08 |
| 1437782257 | Jillian Knapp | Family Medicine | 521 W Butler Dr, Phoenix, AZ 85021-4526 | 2020-02-20 |
| 1861033912 | Vanessa Lissette Lara | Family Medicine | 1459 E Flower St, Phoenix, AZ 85014-5666 | 2019-09-30 |
| 1366007411 | Marceline E Ndum | Family Medicine | 10631 S. 51st Street, Suite 1, Phoenix, AZ 85044-5225 | 2019-05-03 |
| 1306318340 | Leah Margaret Hillier | Family Medicine | 1300 N 12th St - Suite 500, Phoenix, AZ 85006 | 2018-12-31 |
| 1326510389 | Leanne J Muniz | Family Medicine | 19635 N Cave Creek Rd Apt 344, Phoenix, AZ 85024-1879 | 2018-12-31 |
| 1164905535 | Clark Medical, Pllc | Family Medicine | 2601 N 3rd St Ste 106, Phoenix, AZ 85004-1144 | 2018-09-12 |
| 1780180901 | Babymoon Inn Family Care LLC | Family Medicine | 202 E Morris Dr, Phoenix, AZ 85012-2323 | 2018-04-05 |
| Find all providers in PHOENIX | ||||
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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.