MEDICARE: KAY ANN JOHNSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35-057032	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110228310	OTHER	OH	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306802111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAY ANN JOHNSON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 636256 CENTRAL CREDENTIALING
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-6256
Country	:	US
Telephone Number	:	513-585-5501
Fax Number	:	513-585-5511

Provider Business Practice Location Address
First Line	:	9275 MONTGOMERY RD
Second Line	:	STE 200
City	:	CINCINNATI
State	:	OH
Zip	:	45242-7779
Country	:	US
Telephone Number	:	513-936-4510
Fax Number	:	513-936-4511

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	01/19/2018

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Directions to “ KAY ANN JOHNSON M.D.” Practice Location

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