Brady L Johnson
Physician Assistant (Medical)

Address: 4320 Wornall Rd, Suite 710, Kansas City, MO 64111-5941
Phone: 8169322700

Brady L Johnson (NPI# 1336423607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1336423607
Entity Type Individual
Full Name Brady L Johnson
Credential PA
Gender Male
Practice Address 4320 Wornall Rd
Suite 710
Kansas City
MO 64111-5941
Practice Telephone 8169322700
Practice Fax Number 8169322705
Mailing Address 901 E. 104th St.
Mailstop 400n
Kansas City
MO 64131
Mailing Telephone 8165028756
Mailing Fax Number 8169329670
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2011-10-05
Last Update Date 2017-11-16

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
No 363AS0400X Physician Assistant · Surgical Physician Assistants & Advanced Practice Nursing Providers MO
Yes 363AM0700X Physician Assistant · Medical Physician Assistants & Advanced Practice Nursing Providers MO

Other Providers BRADY JOHNSON

NPI Name Taxonomy Address Enumeration
1255820882 Brady Johnson Chiropractor 14555 E Arapahoe Rd Unit B, Aurora, CO 80016-1584 2018-05-09

Physician Overview

NPI 1336423607
PAC ID by PECOS 3375706187
Professional Enrollment ID I20120515000087
Full Name Brady L Johnson
Organization Legal Name SAINT LUKES PHYSICIAN GROUP INC
Phone Number 8165323999
Gender M
Graduation Year 2011
Primary Specialty PHYSICIAN ASSISTANT
Group Practice PAC ID 3577476894
Number of Group Practice Members 798
Accepts Medicare Assignment Y
Report Quality Measures Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
260138 ST LUKES HOSPITAL OF KANSAS CITY
260216 SAINT LUKE'S EAST HOSPITAL
170185 SAINT LUKE'S SOUTH HOSPITAL
260062 SAINT LUKES NORTH HOSPITAL
170133 SAINT LUKE'S CUSHING HOSPITAL

Office Location

Street Address 4320 WORNALL RD
SUITE 710
City KANSAS CITY
State MO
Zip Code 64111-5941

Providers in the same location

NPI Name Taxonomy Address Enumeration
1477556215 Paul W Jenkins Jr. Physician Assistant 4320 Wornall Rd, Ste 50-ii, Kansas City, MO 64111-5941 2005-05-24
1487187316 Suzanne D Cummings Nurse Practitioner 4320 Wornall Rd, Suite 208, Kansas City, MO 64111-5941 2017-04-07
1992256069 Jackie Wallman Occupational Therapist 4320 Wornall Rd, Suite 600, Kansas City, MO 64111-5941 2016-10-24
1053868877 Chelsea J. Light Physician Assistant 4320 Wornall Rd, Suite 50, Kansas City, MO 64111-5941 2016-09-09
1730532250 Brittany Lynn Walker Registered Nurse 4320 Wornall Rd, Suite 240, Kansas City, MO 64111-5941 2016-07-20
1184084535 Justine Uryasz Nurse Practitioner 4320 Wornall Rd, Suite 50, Kansas City, MO 64111-5941 2016-02-28
1104290600 Christina L Cooper Registered Nurse 4320 Wornall Rd, Suite 710, Kansas City, MO 64111-5941 2015-11-20
1295105914 Rebecca Miller Physician Assistant 4320 Wornall Rd, Suite 304, Kansas City, MO 64111-5941 2015-10-07
1891179602 Lauren Ann Ori Physician Assistant 4320 Wornall Rd, Suite 50, Kansas City, MO 64111-5941 2015-07-13
1053794263 Emily Johnston Nurse Practitioner 4320 Wornall Rd, Suite 208, Kansas City, MO 64111-5941 2015-07-07
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1861975005 Adyssa Thompson Nurse Practitioner 3606 Gillham Road, 19, Kansas City, MO 64111 2018-09-13
1558844241 Guardian Angels, LLC Home Health 4049 Pennsylvania Ave, Kansas City, MO 64111 2018-09-10
1861987042 Lyndsay Kidd Registered Nurse 4330 Wornall Rd, Ste 2000, Kansas City, MO 64111 2018-06-28
1720579808 Jacqueline Michelle Johnson Registered Nurse 4321 Washington St Ste 6100, Kansas City, MO 64111 2018-05-23
1316460835 Kandace Callwell Counselor 4106 Baltimore Ave, Kansas City, MO 64111 2017-07-18
1780046250 Sara Koenemann Nurse Practitioner 4400 Broadway St., Ste. 520, Kansas City, MO 64111 2016-03-24
1932586245 Suzzette Griffith Acupuncturist 406 W 34th Street Ste 812, Kansas City, MO 64111 2015-05-06
1972999225 Timothy O Olatunde Student in an Organized Health Care Education/Training Program 4410 Wornall Road, Kansas City, MO 64111 2015-04-14
1730595026 Morgan Nelson Audiologist 4230 Wornall Road, Suite 420, Kansas City, MO 64111 2014-07-07
1679984371 Lauren Regueyra Student in an Organized Health Care Education/Training Program 4320 Wornall Rd Ste 336, Kansas City, MO 64111 2014-05-15
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1457823742 Samantha Jo Belvin Physician Assistant 4321 Washington St Ste 6000, Kansas City, MO 64111-5930 2018-12-26
1457822082 Jwan Alallaf Physician Assistant 4121 Roanoke Rd Apt 18, Kansas City, MO 64111-4053 2018-12-07
1447685375 Elizabeth Kathleen Lowry Physician Assistant 3901 Rainbow Blvd # Ms 3105, Kansas City, KS 66160 2013-09-10
1427017904 Kimberly R. Bogart Physician Assistant 2601 Midwest Dr., Kansas City, KS 66111 2006-03-22
1154831642 David Vaughn Porter Jr. Physician Assistant 2316 E Meyer Blvd, Kansas City, MO 64132-1136 2017-10-10
1487177523 Vinesha Byers Physician Assistant 2316 E Meyer Blvd, Kansas City, MO 64132-1136 2017-07-20
1912441403 Lindsay Mccrite Physician Assistant 340 Southwest Blvd, Kansas City, KS 66103-2150 2016-12-19
1124477195 Katherine Edstrom Shedd Physician Assistant 2401 Gillham Rd, Kansas City, MO 64108-4619 2016-06-09
1194196733 Elizabeth Neubauer Physician Assistant 21 N 12th St, Kansas City, KS 66102-5161 2015-10-08
1912328691 Molly Kurtz Physician Assistant 4240 Blue Ridge Blvd, Suite #611, Kansas City, MO 64133-1713 2013-12-23
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Competitor

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City KANSAS CITY
Zip Code 64111

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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