DR. KENNETH M JOHNSON III (NPI# 1740209410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740209410 |
| Entity Type | Individual |
| Full Name | DR. KENNETH M JOHNSON III |
| Credential | MD |
| Practice Address |
Womack Amc Credentials Ofc Bldg 4-2817, Reilly Rd Fort Bragg NC 28310-0001 |
| Practice Telephone | 9109077000 |
| Mailing Telephone | 9109077000 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2016-08-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 240274 | NY | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487144952 | Kenneth Cornell Johnson Jr. | Counselor | 91 Park Ave W, Mansfield, OH 44902-1630 | 2018-05-10 |
| 1043756414 | Kenneth Byron Johnson | Physical Therapist | 36 Lavelle Court, Unalaska, AK 99685 | 2017-01-10 |
| 1932565280 | Kenneth Johnson | Case Manager/Care Coordinator | 1138 N Dupre St, New Orleans, LA 70119-3204 | 2015-12-31 |
| 1003223298 | Kenneth Johnson | Specialist/Technologist | 6201 San Amaro Dr, Coral Gables, FL 33146-2407 | 2014-07-19 |
| 1831511807 | Kenneth Larry Johnson I | Local Education Agency (LEA) | 216 Ne 19th Ave, Pompano Beach, FL 33060-6743 | 2014-01-10 |
| 1700222544 | Kenneth Paul Johnson | Pharmacist | 506 Augsburg Ave, Bismarck, ND 58504-7005 | 2013-05-20 |
| 1528302635 | Kenneth James Johnson | Pharmacist | 8145 Rhode Island Cir, 1, Bloomington, MN 55438-1152 | 2012-11-15 |
| 1760750194 | Kenneth Casper Johnson | Obstetrics & Gynecology | 3915 Skyline Rd, Carlsbad, CA 92008-2746 | 2011-12-13 |
| 1225305931 | Kenneth Lorenzo Johnson | Psychologist | 7605 W 7 Mile Rd, Detroit, MI 48221-2163 | 2011-11-23 |
| 1528371408 | Kenneth Johnson | Physical Therapist | 10753 Falls Rd Ste 235, Lutherville, MD 21093-4597 | 2010-07-20 |
| Street Address |
WOMACK AMC CREDENTIALS OFC BLDG 4-2817, REILLY RD |
| City | FORT BRAGG |
| State | NC |
| Zip Code | 28310-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013550763 | Brent Francis Bachman | Physician Assistant | 2817 Reilly Street, Fort Bragg, NC 28310 | 2019-10-25 |
| 1417503459 | Cooper Pasque | Dentist | 1838 Normandy Dr., Fort Bragg, Apo, AA 28310 | 2019-08-15 |
| 1851959951 | Daniel Jordan Whitaker | Student in an Organized Health Care Education/Training Program | Womack Army Medical Center, 2817 Reilly Road, Mcxc-cod Credentials, Fort Bragg, NC 28310 | 2019-06-03 |
| 1679054217 | Christopher Cetnar | Dentist | Smokebomb Hill, Bldg 3718 Gruber Road, Fort Bragg, NC 28310 | 2018-08-22 |
| 1316427107 | Alexandrea Lee Clark | Dentist | Laflamme Dental Clinic, Bldg C6238 Ardennes Road, Fort Bragg, NC 28310 | 2018-08-21 |
| 1457843831 | Kevin Patrick Hudson | Student in an Organized Health Care Education/Training Program | 2817 Reilly Road Mxcx - Cod Credentials, Womack Army Medical Center, Fort Bragg, NC 28310 | 2018-06-01 |
| 1639691462 | Margaret S Greene | Dentist | Usa Dental Health Activity Fort Bragg, Wamc Box #151 2817 Rielly Rd, Fort Bragg, NC 28310 | 2017-07-13 |
| 1912432246 | Chezdan Baker | Student in an Organized Health Care Education/Training Program | Us Army Dental Health Activity Bldg-6837 Normandy Drive, Fort Bragg, NC 28310 | 2017-04-24 |
| 1215483094 | Shantryce Monique Boatwright Crump | Dental Hygienist | 2617 Rielly Road, Fort Bragg, NC 28310 | 2016-08-31 |
| 1629435714 | John Gagnier | Physician Assistant | Gruber Road, Building #c-1722, Fort Bragg, NC 28310 | 2016-01-21 |
| Find all providers in zip 28310 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770819641 | Patrick Lenaghan | Emergency Medicine | 707 River Dr, Fort Bragg, CA 95437 | 2009-10-27 |
| 1457518250 | Ryan Melink Knight | Emergency Medicine | Wamc 4 2817 Reilly St, Fort Bragg, NC 28310-0001 | 2008-05-20 |
| 1215114160 | Craig Hamilton Barstow | Emergency Medicine | Womack Army Medical Center; Fmrc, Bldg 4-2817, Fort Bragg, NC 28310-5000 | 2008-01-23 |
| 1629273628 | Christopher Michael House | Emergency Medicine | Bldg D-3534, Fort Bragg, NC 28310-0001 | 2007-06-19 |
| 1932272366 | Shawn Frank Taylor | Emergency Medicine | 2817 Reilly Road Department of Emergency Medicine, Fort Bragg, NC 28310 | 2006-11-15 |
| 1982229993 | John Joseph Reidelbach II | Emergency Medicine | 2817 Reilly St, Fort Bragg, NC 28310-7394 | 2020-06-15 |
| 1710336300 | Glass Beach Medical Services A Medical Corporation | Emergency Medicine | 700 River Dr, Fort Bragg, CA 95437-5403 | 2016-06-06 |
| 1497175384 | Van Wall | Emergency Medicine | 2817 Reilly St, Fort Bragg, NC 28310 | 2014-04-18 |
| 1770716938 | Leigh-anne Lindenmuth Slack | Emergency Medicine | 2817 Reilly Road, Mcxc-cod Credentials Womack Army Medical Center, Fort Bragg, NC 28310 | 2009-09-03 |
| 1144457276 | Samuel Aaron Ralston | Emergency Medicine | 2817 Reilly St, Womack Army Medical Center, Fort Bragg, NC 28310-7324 | 2009-06-16 |
| Find all providers in FORT BRAGG | ||||
| City | FORT BRAGG |
| Zip Code | 28310 |
Please comment or provide details below to improve the information on DR. KENNETH M JOHNSON III.
| 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.