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KENNETH ALLAN JOHNSON M.D.
NPI 1790786820
Orthopaedic Surgery in Statesboro, GA

Active since August 10, 2005PECOS Enrolled
1601 FAIR RD, SUITE 300, STATESBORO, GA 30458(912) 871-6742(912) 871-2563 Get Directions Write a Review

NPPES record last updated: July 7, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kenneth Allan Johnson M.d. NPPES

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

KENNETH ALLAN JOHNSON M.D. (NPI 1790786820) is an individual orthopaedic surgery provider in Statesboro, Georgia, licensed in Georgia (037577) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790786820
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameKENNETH ALLAN JOHNSONCredential: M.D.
Location Address1601 FAIR RD, SUITE 300Statesboro, GA 30458-1698
Mailing Address127 Oak Ridge DrStatesboro, GA 30458-9135 · (912) 871-6742 · Fax (912) 871-2563
Phone(912) 871-6742
Fax(912) 871-2563
Sole ProprietorNo
Enumeration DateAugust 10, 2005
Last NPPES UpdateJuly 7, 2014
✔ NPI 1790786820 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in GA · 037577
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
1601 FAIR RD, Statesboro, GA 30458
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Other Identifiers 3

Medicare ID-Type Unspecified20BDCDBGA
Medicare UPINE11272
Medicaid00572041AGA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenneth Allan Johnson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

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

Catholic Medical Center
921 mi
Vascular Surgery
87 MCGREGOR ST, SUITE 3100
Manchester, NH 03102
  • Reassigned Medicare billing, New Hampshire enrollment
  • 43 clinicians in this Medicare group
NPI 1235370057 (603) 627-1887

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30458 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
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.

COTTON RIDGE PHYSICAL THERAPY LLC
Physical Therapist
1601 FAIR RD, SUITE 100
STATESBORO, GA 30458
Bulloch County (912) 681-7907
LAURIE MICHELLE COLYER PT
Physical Therapist
1601 FAIR RD, SUITE 100
STATESBORO, GA 30458
Bulloch County (912) 681-7860
EAST GEORGIA ORTHOPEDIC CENTER, PC.
Specialist
1601 FAIR RD, SUITE 300
STATESBORO, GA 30458
Bulloch County (912) 871-2563
JOHN EDWARD KIMES PT
Physical Therapist
1601 FAIR RD, SUITE 100
STATESBORO, GA 30458
Bulloch County (912) 681-7907
CHRISTY N BYCZKOSKI FNP
Nurse Practitioner (Family)
1601 FAIR RD, SUITE 400
STATESBORO, GA 30458
Bulloch County (912) 871-8900
MEDICAL DIAGNOSTICS OF STATESBORO LLC
Clinic/Center (Radiology)
1601 FAIR RD, SUITE 1100
STATESBORO, GA 30458
Bulloch County (912) 681-2848
EAST GEORGIA CANCER CENTER
Internal Medicine (Hematology & Oncology)
1601 FAIR RD, #900
STATESBORO, GA 30458
Bulloch County (912) 871-8000
ANDREW V CICHELLI MD INC
Internal Medicine (Pulmonary Disease)
1601 FAIR RD, SUITE 600
STATESBORO, GA 30458
Bulloch County (912) 681-4911

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 Kenneth Johnson's NPI number?

The NPI number for Kenneth Johnson is 1790786820. It was assigned to this individual provider in the NPPES registry on August 10, 2005.

Where is Kenneth Johnson located?

Kenneth Johnson practices at 1601 Fair Rd Suite 300, Statesboro, GA 30458. The listed phone number is (912) 871-6742.

What is Kenneth Johnson's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Kenneth Johnson enrolled in Medicare?

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

Which organization bills Medicare for Kenneth Johnson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Johnson reassigns Medicare benefits to Catholic Medical Center (Manchester, NH). 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 Kenneth 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 Kenneth Johnson was last updated on July 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.