KATHLEEN JOHNSON (NPI# 1831177559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831177559 |
| Entity Type | Individual |
| Full Name | KATHLEEN JOHNSON |
| Practice Address |
5409 N Knoxville Ave Peoria IL 61615 |
| Mailing Address |
Po Box 3853 Peoria IL 61612-3853 |
| Practice Telephone | 3096827750 |
| Practice Fax Number | 3096827786 |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | HEALTHLINK | 239090 | 01 |
| IL | BLUE CROSS BLUE SHIELD | 0007222342 | 01 |
| IL | 036065748-1 | 05 | |
| IL | JOHN DEERE | IL0100 | 01 |
| IL | HEALTH ALLIANCE | 058975 | 01 |
| IL | ACR | 1431758 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073161519 | Kathleen Johnson | Technician | 7436 Hinton Park Ave South, Cottage Grove, MN 55016 | 2019-08-28 |
| 1083129613 | Kathleen Yezek Johnson | Speech-Language Pathologist | 4700 School Rd, Ringwood, IL 60072-9606 | 2017-12-05 |
| 1366966616 | Kathleen M Johnson | Registered Nurse | 3525 W Oxford Ave Unit G-2, Denver, CO 80236-3114 | 2017-07-28 |
| 1912433889 | Kathleen Johnson | Dietitian, Registered | 1635 Belt St, Baltimore, MD 21230-4705 | 2017-05-11 |
| 1700214392 | Kathleen Johnson | Nurse Practitioner | 30 E Huron St Apt 1002, Chicago, IL 60611-2742 | 2013-10-17 |
| 1942541503 | Kathleen Anne Johnson | Speech-Language Pathologist | 841 N Downs St Ste C, Ridgecrest, CA 93555-3380 | 2013-03-07 |
| 1386922441 | Kathleen O'hara Johnson | Internal Medicine | 6330 Riverdale Rd, Riverdale, GA 30274-1617 | 2011-07-23 |
| 1124310198 | Kathleen Theresa Johnson | Nurse Practitioner | 113 N Campbell Rd, Royal Oak, MI 48067-2345 | 2011-05-10 |
| 1497071641 | Kathleen Johnson | Adult Companion | 208 Maple St., Apt. 208, Big Rapids, MI 49307 | 2010-04-13 |
| 1710165360 | Kathleen Mcgraw Johnson | Social Worker | 22800 Golfview Dr, Southfield, MI 48033-6648 | 2008-02-06 |
| Street Address |
5409 N KNOXVILLE AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033116876 | Proctor Community Hospital | General Acute Care Hospital | 5409 N Knoxville Ave, Peoria, IL 61614-5016 | 2005-07-07 |
| 1124637848 | Erin K Hocker | Occupational Therapist | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2020-07-28 |
| 1548804925 | Susan Carrasco | Speech-Language Pathologist | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2019-10-29 |
| 1083270938 | Christine Shaw | Hospitalist | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2019-05-16 |
| 1043779861 | Chelsea Krejci | Nurse Practitioner | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2019-03-19 |
| 1841757077 | Abby Marie Taube | Occupational Therapist | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2019-02-24 |
| 1164905014 | Felicia Williams-triplett | Registered Nurse | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2018-09-06 |
| 1871001644 | Cassie J Stone | Nurse Practitioner | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2018-01-16 |
| 1053854323 | Alicia Layton | Nurse Practitioner | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2016-11-18 |
| 1457706624 | Aimee Parrott | Nurse Practitioner | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2016-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
| 1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
| 1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
| 1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
| Find all providers in zip 61615 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1932490075 | Christine Ann Wigginton | Radiology | 221 Ne Glen Oak Ave Dept Of, Peoria, IL 61636 | 2011-04-24 |
| 1932421591 | Smi Imaging, LLC | Radiology | 9125 W Thunderbird Rd, Suite 105, Peoria, AZ 85381-4920 | 2010-02-24 |
| 1972736163 | Smi Imaging, LLC | Radiology | 9403 W Thunderbird Rd, Peoria, AZ 85381-4825 | 2009-09-03 |
| 1184828360 | Jane Ho Maksimovic | Radiology | 2612 W Newman Pkwy, Peoria, IL 61604-2208 | 2007-06-12 |
| 1124030705 | Terry M Brady | Radiology | 411 Hamilton Blvd, 1824, Peoria, IL 61602-1144 | 2006-08-12 |
| 1275543456 | Kim V. Arellano-villarreal | Radiology | 401 Sw Water St, Peoria, IL 61602-1571 | 2006-08-09 |
| 1386659241 | Central Illinois Radiological Associates, Ltd. | Radiology | Osf St Francis Medical Ctr, 530 N.e. Glen Oak, Peoria, IL 61636-0001 | 2006-07-29 |
| 1538192828 | Central Illinois Radiological Associates, Ltd. | Radiology | 530 Ne Glen Oak Avenue, Peoria, IL 61637 | 2006-07-09 |
| 1265469399 | Brian A Holtan | Radiology | 31003 N 118th Ln, Peoria, AZ 85383-8240 | 2006-06-26 |
| Find all providers in PEORIA | ||||
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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.