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KIM DAVID JOHNSON M.D.
NPI 1902987936
Family Medicine in Phoenix, AZ

Active since October 18, 2006Opted out of Medicare · through Jun 27, 2027
4840 E INDIAN SCHOOL RD, STE. 101, PHOENIX, AZ 85018(602) 224-1900(602) 224-9444 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kim David Johnson M.d. NPPES

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

KIM DAVID JOHNSON M.D. (NPI 1902987936) is an individual family medicine provider in Phoenix, Arizona, licensed in Arizona (19257) and active in the NPI registry since October 2006. He has opted out of Medicare through June 27, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1902987936
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameKIM DAVID JOHNSONCredential: M.D.
Location Address4840 E INDIAN SCHOOL RD, STE. 101Phoenix, AZ 85018-5500
Mailing Address4840 E Indian School Rd, Ste. 101Phoenix, AZ 85018-5500 · (602) 224-1900 · Fax (602) 224-9444
Phone(602) 224-1900
Fax(602) 224-9444
Sole ProprietorNo
Enumeration DateOctober 18, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1902987936 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in AZ · 19257
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4840 E INDIAN SCHOOL RD, Phoenix, AZ 85018
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Other Identifiers 2

Medicare ID-Type UnspecifiedZ26156AZ
Medicare UPINE83088AZ

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Kim David Johnson M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 27, 2019 through June 27, 2027.

Opt-Out Effective DateJune 27, 2019
Opt-Out In Effect ThroughJune 27, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85018 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
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 17

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

SEIVERT ORTHOPEDICS & SPROTS MEDICINE, P.C.
Orthopaedic Surgery (Sports Medicine)
4840 E INDIAN SCHOOL RD, SUITE 104
PHOENIX, AZ 85018
Maricopa County (602) 265-9900
SCOTTSDALE HEALTHCARE CORP
Family Medicine
4840 E INDIAN SCHOOL RD, SUITE 101
PHOENIX, AZ 85018
Maricopa County (602) 224-1900
TERESA LYNN RYAN P.A.
Physician Assistant
4840 E INDIAN SCHOOL RD, SUITE 100
PHOENIX, AZ 85018
Maricopa County (602) 508-2900
MRS. TINA LYNN BUSBY F.N.P.
Nurse Practitioner (Family)
4840 E INDIAN SCHOOL RD, SUITE 101
PHOENIX, AZ 85018
Maricopa County (602) 224-1900
GLENDA MARTYNE BLANCHARD N.P.
Registered Nurse (General Practice)
4840 E INDIAN SCHOOL RD, SUITE 100
PHOENIX, AZ 85018
Maricopa County (602) 508-2900
DR. STACY ELIZABETH GUSTIN D.O.
Family Medicine
4840 E INDIAN SCHOOL RD, SUITE 100
PHOENIX, AZ 85018
Maricopa County (480) 882-7360
ASSOCIATED FAMILY PHYSICIANS, P.C.
Family Medicine
4840 E INDIAN SCHOOL RD, SUITE 100
PHOENIX, AZ 85018
Maricopa County (602) 508-2920
ERICA RENEE NOEL P.T.
Physical Therapist
4840 E INDIAN SCHOOL RD, SUITE 103
PHOENIX, AZ 85018
Maricopa County (602) 956-2850

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 Kim Johnson's NPI number?

The NPI number for Kim Johnson is 1902987936. It was assigned to this individual provider in the NPPES registry on October 18, 2006.

Where is Kim Johnson located?

Kim Johnson practices at 4840 E Indian School Rd Ste. 101, Phoenix, AZ 85018. The listed phone number is (602) 224-1900.

What is Kim Johnson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kim Johnson enrolled in Medicare?

No. Kim Johnson has opted out of Medicare through June 27, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Kim Johnson was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.