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

Individual provider Physician Assistant · NPI 1821718057

Kiesha Charis Johnson is a Physician Assistant in Durham, North Carolina. Qualified in 2022, 4 years ago. Practices with North Carolina Mg LLC, a 712-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
4
Licensed in
NC
In the registry since
2022
Specialties on file
3
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Practice location Address checks out

2314 Nation Ave Apt 4
Durham, NC 27707-2015
Phone: (973) 489-1294
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 509 N Brightleaf Blvd, Smithfield, NC 27577-4407 — (919) 938-7189

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-13367 (NC)
Physician Assistant Taxonomy 363A00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1821718057
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 29, 2022
Last updated in NPPESMarch 12, 2025
Certification dateMarch 12, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice North Carolina Mg Llc — 712 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Durham