Ms Kem Jacqueline Johnson, MS, MED, CNS, LDN is a medicare enrolled "Nutritionist" provider in Baltimore, Maryland. Her current practice location is
1111 N Charles St, Baltimore, Maryland. You can reach out to her office (for appointments etc.) via phone at
(410) 837-2050.
Ms Kem Jacqueline Johnson is licensed to practice in Maryland (license number DX5837) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1083857312.
Healthcare Provider's Profile
Full Name | Ms Kem Jacqueline Johnson |
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Gender | Female |
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Speciality | Nutritionist |
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Location | 1111 N Charles St, Baltimore, Maryland |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1083857312
- Provider Enumeration Date: 04/16/2009
- Last Update Date: 06/07/2023
Medicare PECOS Information:
- PECOS PAC ID: 9436512464
- Enrollment ID: I20230824000227
Medical Identifiers
Medical identifiers for Ms Kem Jacqueline Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1083857312 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | SC1018 (Maryland) | Secondary |
133N00000X | Nutritionist | DX5837 (Maryland) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Kem Jacqueline Johnson allows following entities to bill medicare on her behalf.
Entity Name | Chase Brexton Health Services Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1588606305 PECOS PAC ID: 5395644835 Enrollment ID: O20040512000520 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Kem Jacqueline Johnson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ms Kem Jacqueline Johnson, MS, MED, CNS, LDN 1111 N Charles St, Baltimore, MD 21201-5505 Ph: (410) 837-2050 | Ms Kem Jacqueline Johnson, MS, MED, CNS, LDN 1111 N Charles St, Baltimore, MD 21201-5505 Ph: (410) 837-2050 |
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