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

Kyle Johnson, DO

Individual provider Family Medicine Physician · NPI 1174053920

Kyle Johnson, DO is a Family Practice in Saint Louis, Missouri. Qualified in 2017, 9 years ago. Practices with Mercy Clinic East Communities, a 573-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Missouri.

Years since qualifying
9
Licensed in
MO
In the registry since
2017
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

12680 Olive Blvd Ste 300
Saint Louis, MO 63141-6322
Phone: (314) 251-8888
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 2017019521 (MO)

Record details

NPI number1174053920
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedJune 14, 2017
Last updated in NPPESJune 14, 2017

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Mercy Clinic East Communities — 573 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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