DR. WALTER KIP JOHNSON M.D.
NPI 1780919282
General Practice in Ione, CA
About Dr. Walter Kip Johnson M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. WALTER KIP JOHNSON M.D. (NPI 1780919282) is an individual general practice provider in Ione, California, licensed in California (G32232) and active in the NPI registry since October 2009. He is enrolled in Medicare PECOS, maintains a secondary practice location in Jackson, and is a graduate of Other (1975).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Walter Kip Johnson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Walter Johnson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Andreas, CA 95249
- Reassigned Medicare billing, Texas enrollment
- 41 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Referred Medical Equipment & Supplies CMS DME claims 7
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Walter Johnson's NPI number?
The NPI number for Walter Johnson is 1780919282. It was assigned to this individual provider in the NPPES registry on October 16, 2009. The provider is also known as Dr. W. Kip Johnson M.D..
Where is Walter Johnson located?
Walter Johnson practices at 305 Preston Ave, Ione, CA 95640. The listed phone number is (209) 742-6144.
What is Walter Johnson's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is Walter Johnson enrolled in Medicare?
Yes. Walter Johnson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Walter Johnson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Walter Johnson reassigns Medicare benefits to M A C T Health Board Incorporated (San Andreas, CA). 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 Walter 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 Walter Johnson was last updated on March 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Dr. Walter Kip Johnson, M.D. · NPI 1780919282
General Practice physician in Ione, California. Individual provider, active in the CMS NPPES registry since October 16, 2009.
## Identity
- **NPI:** 1780919282 (Entity type: Individual)
- **Enumerated:** October 16, 2009
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **State license:** G32232 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 305 PRESTON AVE, Ione, CA 95640-9158
- **Phone:** (209) 742-6144
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** M A C T Health Board Incorporated (NPI 1366519431, San Andreas, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1975
## Record status
- **NPPES last updated:** March 3, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1780919282) · Data from the CMS NPPES public registry.