KELLY DYESS JOHNSON MD
NPI 1487236295
Pediatrics in Gulfport, MS

Q: What is Kelly Johnson's NPI number?

The NPI number for Kelly Johnson is 1487236295. It was assigned to this individual provider in the NPPES registry on April 22, 2021. The provider is also known as Lauren Kelly Dyess.

Q: What is Kelly Johnson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Johnson was last updated on December 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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 April 22, 2021PECOS Enrolled

4500 13TH ST, GULFPORT, MS 39501(228) 867-4000 Get Directions Write a Review

NPPES record last updated: December 30, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 30, 2025, Apr 22, 2021 (2 updates tracked since 2021).

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About Kelly Dyess Johnson Md NPPES

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

KELLY DYESS JOHNSON MD (NPI 1487236295) is an individual pediatrics provider in Gulfport, Mississippi, licensed in Mississippi (36112) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1487236295

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameKELLY DYESS JOHNSONCredential: MD

Location Address4500 13TH STGulfport, MS 39501-2515

Mailing Address4500 13th StGulfport, MS 39501-2515 · (228) 867-4000

Phone(228) 867-4000

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateApril 22, 2021

Last NPPES UpdateDecember 30, 20252 updates tracked since enumeration

NPPES CertifiedDecember 30, 2025

✔ NPI 1487236295 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in MS · 36112

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

4500 13TH ST, Gulfport, MS 39501

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Other Names 1

Former Name (1)Lauren Kelly Dyess

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Dyess Johnson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1658777073

PECOS Enrollment IDI20260508003251

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEATHER LYN JEFFREY

Nurse Practitioner