Individual ProviderKenneth JohnsonCase Manager/Care CoordinatorOther Service ProvidersPractice Address1138 N Dupre St, New Orleans, LA 70119-3204(504) 330-1998PECOS EnrollmentBased on the most recent information from CMS, provider Kenneth Johnson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1932565280Provider TypeIndividualFull NameJohnson, KennethGenderMaleSole ProprietorNoEnumeration Date12/31/2015Last Updated7/21/2022Contact InformationPractice LocationPractice Address1138 N Dupre St, New Orleans, LA 70119-3204Phone(504) 330-1998Fax(504) 330-1998Mailing LocationMailing Address1138 N. Dupre St., New Orleans, LA 70119-2609Phone(504) 330-1998FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer