Kelly Jo Johnson, RDN, CD - Medicare Dietitian in Cumberland, WI

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Kelly Jo Johnson, RDN, CD is a medicare enrolled "Dietitian, Registered" provider in Cumberland, Wisconsin. Her current practice location is 1705 16th Ave, Cumberland, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (715) 822-7500.

Kelly Jo Johnson is licensed to practice in Wisconsin (license number 2237-29) 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 1760994917.

Contact Information

Kelly Jo Johnson, RDN, CD
1705 16th Ave,
Cumberland, WI 54829-8601
(715) 822-7500
(715) 822-7501

Map and Direction




Healthcare Provider's Profile

Full NameKelly Jo Johnson
GenderFemale
SpecialityDietitian, Registered
Location1705 16th Ave, Cumberland, Wisconsin
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1760994917
  • Provider Enumeration Date: 10/27/2017
  • Last Update Date: 02/18/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 0547523128
  • Enrollment ID: I20180412001231

Medical Identifiers

Medical identifiers for Kelly Jo Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1760994917NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
133V00000XDietitian, Registered 2237-29 (Wisconsin)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. Kelly Jo Johnson allows following entities to bill medicare on her behalf.
Provider NameCumberland Memorial Hospital Inc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1831243757
PECOS PAC ID: 7719889203
Enrollment ID: O20040124000061

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. Kelly Jo 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 AddressPractice Location Address
Kelly Jo Johnson, RDN, CD
1705 16th Ave,
Cumberland, WI 54829-8601

Ph: (715) 822-7500		Kelly Jo Johnson, RDN, CD
1705 16th Ave,
Cumberland, WI 54829-8601

Ph: (715) 822-7500

Reviews and Comments


Dietitian, Registered in Cumberland, WI

Susan Rouzer,
Dietitian
Medicare: Not Enrolled in Medicare
Practice Location: 1110 7th Ave, Cumberland, WI 54829
Phone: 715-822-2741    
Kiersten Haugerud,
Dietitian
Medicare: Medicare Enrolled
Practice Location: 1110 7th Ave, Cumberland, WI 54829
Phone: 715-822-7200    Fax: 715-822-7221
Ally Roberts, RD
Dietitian
Medicare: Medicare Enrolled
Practice Location: 1110 7th Ave, Cumberland, WI 54829
Phone: 715-822-7200    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.