KIMBERLY JOHNSON RD
NPI 1114665395
Dietitian, Registered in Lauderdale By The Sea, FL

Q: What is Kimberly Johnson's NPI number?

The NPI number for Kimberly Johnson is 1114665395. It was assigned to this individual provider in the NPPES registry on May 26, 2022.

Q: What is Kimberly Johnson's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Q: When was this NPI record last updated?

The NPPES record for Kimberly Johnson was last updated on June 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 26, 2022

4213 EL MAR DR APT 4, LAUDERDALE BY THE SEA, FL 33308(918) 630-1578 Get Directions Write a Review

NPPES record last updated: June 6, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 6, 2022, May 26, 2022 (2 updates tracked since 2022).

On this page

About Kimberly Johnson Rd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY JOHNSON RD (NPI 1114665395) is an individual dietitian, registered in Lauderdale By The Sea, Florida, licensed in Florida (10842) and active in the NPI registry since May 2022.

NPPES Registry Identity

NPI1114665395

Entity TypeIndividualFemale

Primary Taxonomy133V00000X

Provider Legal NameKIMBERLY JOHNSONCredential: RD

Location Address4213 EL MAR DR APT 4Lauderdale By The Sea, FL 33308-5420

Mailing Address4213 El Mar Dr Apt 4Lauderdale By The Sea, FL 33308-5420 · (918) 630-1578

Phone(918) 630-1578

Sole ProprietorNo

Enumeration DateMay 26, 2022

Last NPPES UpdateJune 6, 20222 updates tracked since enumeration

NPPES CertifiedJune 6, 2022

✔ NPI 1114665395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers

Taxonomy Code133V00000X

License✔ Licensed in FL · 10842

Definition

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

4213 EL MAR DR APT 4, Lauderdale By The Sea, FL 33308

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kimberly Johnson Rd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Kimberly Johnson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Dietitian Group Corporation

12 mi

Nutritionist

7440 SAN CLEMENTE PL
Boca Raton, FL 33433

Reassigned Medicare billing, Florida enrollment
5 clinicians in this Medicare group

NPI 1093312381 (718) 877-4937

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Johnson's NPI number?

The NPI number for Kimberly Johnson is 1114665395. It was assigned to this individual provider in the NPPES registry on May 26, 2022.

Where is Kimberly Johnson located?

Kimberly Johnson practices at 4213 El Mar Dr Apt 4, Lauderdale By The Sea, FL 33308. The listed phone number is (918) 630-1578.

What is Kimberly Johnson's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Kimberly Johnson enrolled in Medicare?

Yes. Kimberly Johnson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kimberly Johnson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Johnson reassigns Medicare benefits to Dietitian Group Corporation (Boca Raton, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimberly Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kimberly Johnson accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Cigna HealthCare of Florida, Inc. and Cigna Healthcare list Kimberly Johnson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kimberly Johnson was last updated on June 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.