Kavin J Johnson (NPI# 1689673105, PAC ID# 7618981598) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1689673105 |
| PAC ID by PECOS | 7618981598 |
| Professional Enrollment ID | I20060201000161 |
| Full Name | Kavin J Johnson |
| Organization Legal Name | PREFERRED FAMILY MEDICAL CARE LLC |
| Address |
9029 Hiwassee Nest Charleston TN 37310 |
| Phone Number | 4236659026 |
| Gender | M |
| Credential | MD |
| Medical School | HOWARD UNIVERSITY COLLEGE OF MEDICINE |
| Graduation Year | 1981 |
| Primary Specialty | FAMILY PRACTICE |
| Group Practice PAC ID | 6800013608 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 9029 Hiwassee Nest, Charleston, TN 37310 | 4236659026 | PREFERRED FAMILY MEDICAL CARE LLC |
| Organization Legal Name | PREFERRED FAMILY MEDICAL CARE LLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cecil Dewayne Knight | General Practice | Preferred Family Medical Care LLC | 9026 Hiwassee Nest, Charleston, TN 37310-5305 |
| Keith L Kidd | Nurse Practitioner | Preferred Family Medical Care LLC | 9026 Hiwassee Nest, Charleston, TN 37310-5305 |
| Street Address |
9029 HIWASSEE NEST |
| City | CHARLESTON |
| State | TN |
| Zip | 37310 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cecil Dewayne Knight | General Practice | Preferred Family Medical Care LLC | 9026 Hiwassee Nest, Charleston, TN 37310-5305 |
| Keith L Kidd | Nurse Practitioner | Preferred Family Medical Care LLC | 9026 Hiwassee Nest, Charleston, TN 37310-5305 |
| City | CHARLESTON |
| Zip Code | 37310 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | CHARLESTON + FAMILY PRACTICE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.