Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Kimberly D. Johnson, MD

Individual provider Family Medicine Physician · NPI 1396717104

Dr. Kimberly D. Johnson, MD is a Family Practice in Rolla, Missouri. Graduated from Wright State University Boonshoft School of Medicine in 1995, 31 years ago. Practices with South Central Missouri Community Health Center, a 13-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
31
Trained at
Wright State University Boonshoft School of Medicine
Licensed in
MO
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1081 E 18th St
Rolla, MO 65401-2448
Phone: (734) 262-4075
Fax: (573) 426-6723
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 2006002908 (MO)

Record details

NPI number1396717104
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 6, 2006
Last updated in NPPESJuly 29, 2020
Certification dateJuly 29, 2020
Mailing address1081 E 18th St, Rolla, MO 65401-2448

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolWRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Graduated 1995 (31 years in practice)
Group practice South Central Missouri Community Health Center — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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