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

Kyle Robert Johnson, MD

Individual provider Emergency Medicine Physician · NPI 1063972487

Kyle Robert Johnson, MD is an Emergency Medicine in Douglas, Wyoming. Graduated from Oregon Health & Sciences Univ School of Dentistry in 2021, 5 years ago. Practices with Memorial Hospital of Converse County, a 80-clinician group and accepts Medicare assignment. Licensed in Wyoming.

Years since qualifying
5
Trained at
Oregon Health & Sciences Univ School of Dentistry
Licensed in
WY
In the registry since
2019
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

111 S 5th St
Douglas, WY 82633-2434
Phone: (307) 358-2122
Show map & directions

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

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 16983A (WY)

Record details

NPI number1063972487
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 21, 2019
Last updated in NPPESJune 24, 2024
Certification dateJune 24, 2024
Mailing address111 S 5th St, Douglas, WY 82633-2434

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOREGON HEALTH & SCIENCES UNIV SCHOOL OF DENTISTRY
Graduated 2021 (5 years in practice)
Group practice Memorial Hospital Of Converse County — 80 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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