KYLE JOHNSON (NPI# 1174053920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174053920 |
| Entity Type | Individual |
| Full Name | KYLE JOHNSON |
| Credential | DO |
| Practice Address |
12680 Olive Blvd Ste 300 Saint Louis MO 63141-6322 |
| Mailing Address |
615 S New Ballas Rd Saint Louis MO 63141-8221 |
| Practice Telephone | 3142518888 |
| Mailing Telephone | 3142518888 |
| Mailing Fax Number | 3142518889 |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2017-06-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2017019521 | MO | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235690066 | Kyle Johnson | Case Manager/Care Coordinator | 1809 Brighton Ave, Oklahoma City, OK 73120-1111 | 2019-03-26 |
| 1548720816 | Kyle Patrick Johnson | Physician Assistant | 2955 Clay St Apt 1, San Francisco, CA 94115-1766 | 2019-03-22 |
| 1518492784 | Kyle Ann Johnson | Counselor | 25 S Ewing St Ste 511, Helena, MT 59601-5732 | 2017-04-25 |
| 1801320577 | Kyle Johnson | Pharmacist | 2198 6th Ave, Cadillac, MI 49601-8896 | 2017-04-19 |
| 1588014021 | Kyle Johnson | Dental Hygienist | 1109 S Park St Ste 504, Carrollton, GA 30117-4449 | 2016-06-15 |
| 1730307570 | Kyle E. Johnson | Psychiatry & Neurology | 515 Enterprise Dr, Suite 300, Lowell, AR 72745-8975 | 2007-04-24 |
| 1699785410 | Kyle Dale Johnson | Optometrist | 1104 E Ohio St, Clinton, MO 64735-2458 | 2006-08-08 |
| 1366042855 | Kyle Johnson | Pharmacist | 161 N Walmart Dr, Harrison, AR 72601-1960 | 2020-10-26 |
| 1083226559 | Kyle Johnson | Behavior Technician | 225 Cedar Hill St Ste 200, Marlborough, MA 01752-5900 | 2020-08-17 |
| 1477162071 | Kyle Douglas Johnson | Dentist | 5800 Coit Rd Ste 700, Plano, TX 75023-5946 | 2020-07-29 |
| Street Address |
12680 OLIVE BLVD STE 300 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-6322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063568640 | Christian Verry | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2007-01-26 |
| 1013533645 | Viola Hoxha | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2020-06-19 |
| 1417573072 | Michele Sun | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2020-06-19 |
| 1639795552 | Catherine Rose Baker | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2020-06-17 |
| 1780208611 | Raphael Kai-hung Yang | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2020-06-06 |
| 1043834427 | Elizabeth Hoover | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2020-06-02 |
| 1992365092 | Shivi Yadava | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2019-06-19 |
| 1588224190 | Emily June Govro | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2019-06-17 |
| 1437718384 | Ha Thuy Hatley | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2019-06-12 |
| 1881253235 | Adam Joseph Reinagel | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2019-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| 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 |
|---|---|---|---|---|
| 1356986541 | Pain Relief Center of St Louis LLC | Family Medicine | 1115 Olivette Executive Pkwy, Saint Louis, MO 63132-3259 | 2019-11-12 |
| 1720635329 | Mercy Clinic East Communities | Family Medicine | 10004 Kennerly Rd Ste 395b, Saint Louis, MO 63128-2190 | 2019-08-20 |
| 1063066777 | Isabella Citizens for Health, Inc. | Family Medicine | 312 Union St, Saint Louis, MI 48880-1830 | 2019-07-31 |
| 1043864010 | Isabella Citizens for Health, Inc. | Family Medicine | 113 E Saginaw St, Saint Louis, MI 48880-1755 | 2019-07-29 |
| 1558896969 | Shivani Sockanathan | Family Medicine | 969 N Mason Rd Ste 145a, Saint Louis, MO 63141-6282 | 2017-04-23 |
| 1598299646 | Kharole Compere | Family Medicine | 175 N Oaks Plz, Saint Louis, MO 63121-2925 | 2017-04-16 |
| 1396109880 | Ritesh Gandhi | Family Medicine | 7345 Watson Rd Ste 203, Saint Louis, MO 63119 | 2016-04-11 |
| 1144608035 | Daniel Urcuyo | Family Medicine | 4625 Lindell Blvd Ste 338, Saint Louis, MO 63108 | 2015-05-11 |
| 1376958728 | Jamil Neme | Family Medicine | 3660 Vista Ave Ste 103, Saint Louis, MO 63110-2540 | 2014-06-24 |
| 1144633819 | Perini Shah | Family Medicine | 12700 Southfork Rd Ste 215, Saint Louis, MO 63128-3276 | 2014-06-10 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63141 |
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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.