KIMBERLY SANDERS JOHNSON PA NPI 1821320656

NPI Information

NPI: 1821320656
Provider Name: KIMBERLY SANDERS JOHNSON, PA
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
9430 PARK WEST BLVD
# 130
KNOXVILLE, TN
ZIP 37923
Phone: (865) 690-4861
Get Directions

Kimberly Sanders Johnson, PA is a surgical physician assistant in Knoxville, TN. Kimberly Sanders Johnson, PA NPI is 1821320656. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

9430 PARK WEST BLVD
# 130
KNOXVILLE, TN
ZIP 37923-200
Phone: (865) 690-4861
Fax: (865) 560-8252

The NPI 1821320656 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/4/2010 and was last updated on 2/1/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		PA0000001820	TENNESSEE	No
2	363AS0400X	Physician Assistant	Surgical	TEMPORARY PERMIT	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	103I970670	MEDICARE PIN	TENNESSEE
2	0677340001	MEDICARE NSC	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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