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KELLY JO JOHNSON RDN, CD
NPI 1760994917
Dietitian, Registered in Cumberland, WI

Active since October 27, 2017
1705 16TH AVE, CUMBERLAND, WI 54829(715) 822-7500(715) 822-7501 Get Directions Write a Review

NPPES record last updated: February 18, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kelly Jo Johnson Rdn, Cd NPPES

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

KELLY JO JOHNSON RDN, CD (NPI 1760994917) is an individual dietitian, registered in Cumberland, Wisconsin, licensed in Wisconsin (2237-29) and active in the NPI registry since October 2017.

NPPES Registry Identity

NPI1760994917
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameKELLY JO JOHNSONCredential: RDN, CD
Location Address1705 16TH AVECumberland, WI 54829-8601
Mailing Address1705 16th AveCumberland, WI 54829-8601 · (715) 822-7500 · Fax (715) 822-7501
Phone(715) 822-7500
Fax(715) 822-7501
Sole ProprietorNo
Enumeration DateOctober 27, 2017
Last NPPES UpdateFebruary 18, 2026
NPPES CertifiedFebruary 18, 2026
✔ NPI 1760994917 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 WI · 2237-29
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.
1705 16TH AVE, Cumberland, WI 54829
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Jo Johnson Rdn, Cd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

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

Cumberland Memorial Hospital Inc
Same address
Critical Access
1705 16TH AVE
Cumberland, WI 54829
  • Reassigned Medicare billing, Wisconsin enrollment
  • 23 clinicians in this Medicare group
NPI 1831243757 (715) 822-7500

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

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.

SARAH KATHERINE FARR FNP-C
Nurse Practitioner (Family)
1705 16TH AVE
CUMBERLAND, WI 54829
Barron County (715) 822-7500
ADAM NETER MD
Family Medicine
1705 16TH AVE
CUMBERLAND, WI 54829
Barron County (715) 822-7500
CUMBERLAND MEMORIAL HOSPITAL, INC
Pharmacy (Community/Retail Pharmacy)
1705 16TH AVE
CUMBERLAND, WI 54829
Barron County (715) 822-7548
ASHLEY RAE KNUTSON DPT, LAT
Physical Therapist
1705 16TH AVE
CUMBERLAND, WI 54829
Barron County (715) 822-7300
AMY MARIE NELSON D.P.T.
Physical Therapist
1705 16TH AVE
CUMBERLAND, WI 54829
Barron County (715) 822-7300
JENNIFER MURDZA FNP-BC
Nurse Practitioner (Family)
1705 16TH AVE
CUMBERLAND, WI 54829
Barron County (715) 822-7500
TESSA LEA FEENEY APNP
Nurse Practitioner
1705 16TH AVE
CUMBERLAND, WI 54829
Barron County (715) 822-7500
ASHLEY MIKAILA MOLLS COTA
Occupational Therapy Assistant
1705 16TH AVE
CUMBERLAND, WI 54829
Barron County (714) 822-7300

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 Kelly Johnson's NPI number?

The NPI number for Kelly Johnson is 1760994917. It was assigned to this individual provider in the NPPES registry on October 27, 2017.

Where is Kelly Johnson located?

Kelly Johnson practices at 1705 16th Ave, Cumberland, WI 54829. The listed phone number is (715) 822-7500.

What is Kelly Johnson's specialty?

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

Is Kelly Johnson enrolled in Medicare?

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

Which organization bills Medicare for Kelly Johnson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Johnson reassigns Medicare benefits to Cumberland Memorial Hospital Inc (Cumberland, WI). 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 Kelly Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kelly Johnson was last updated on February 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.