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

Kevin Mark Johnson

Individual provider School Counselor · NPI 1508515917

Kevin Mark Johnson is a Nurse Practitioner in East Point, Georgia. Qualified in 2020, 6 years ago. Practices with Wellstar Medical Group LLC, a 3,072-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
6
Licensed in
GA
In the registry since
2022
Specialties on file
2

Practice location Address checks out

1170 Cleveland Ave
East Point, GA 30344-3615
Phone: (404) 466-1249
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN171627 (GA)
School Counselor Taxonomy 101YS0200X

Record details

NPI number1508515917
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 22, 2022
Last updated in NPPESAugust 8, 2025
Certification dateAugust 8, 2025
Mailing address106 Cherry Hill Ln, Stockbridge, GA 30281-7359

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Wellstar Medical Group Llc — 3072 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare