DR. KIMBERLY D. JOHNSON (MD) – Family Medicine Physician, NPI 1396717104
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,330 FAMILY PRACTICE in MO
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Provider Addresses for DR. KIMBERLY D. JOHNSON (MD)
Tara Day Spa, 1081, East 18th Street, Rolla, Phelps County, Missouri, 65401, United States
ROLLA, MO 654012448
Phone: (573) 426-4455
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $217.
Total Amount is formed as General ($217) + Research ($0) + Ownership ($0) = $217.
Last reported payment date: 2024-11-05 • Largest payer in this snapshot: Indivior Inc. ($63).
Total Amount
$217
General + Research + Ownership
Payments
13
Total payment records
General Amount
$217
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Indivior Inc. | $63 |
| ABBVIE INC. | $33 |
| Alkermes, Inc. | $28 |
| Braeburn Inc. | $27 |
| Abbott Laboratories | $22 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2006-08-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060818000019 | I | Family Practice | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 83037 | Hemoglobin a1c level, by device for home use | 20 | 14 | $0 |
Insurance plans in this area (ZIP 65401)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | MO | 81002 | Urinalysis, manual test | 35 | 30 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Family Practice | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | KS | |
| Nurse Practitioner | IL | |
| General Practice | MO | |
| Family Practice | MO | |
| Nurse Practitioner | MO |
Reviews
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