MR. JON DAVID JOHNSON (ARNP) – Family Nurse Practitioner, NPI 1730179698
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MR. JON DAVID JOHNSON (ARNP)
12049 SW 76TH TER
LAKE BUTLER, FL 320547724
Phone: (386) 496-4428
Type: Mailing
495, East Main Street, Lake Butler, Union County, Florida, 32054, United States
LAKE BUTLER, FL 320541731
Phone: (386) 496-3211
Fax: (386) 496-1599
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $22.
Total Amount is formed as General ($22) + Research ($0) + Ownership ($0) = $22.
Last reported payment date: 2024-10-09 • Largest payer in this snapshot: Abbott Laboratories ($22).
Total Amount
$22
General + Research + Ownership
Payments
1
Total payment records
General Amount
$22
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $22 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-01-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040108000760 | I | Nurse Practitioner | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32054)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OH | |
| Nurse Practitioner | FL | |
| Physician Assistant | FL | |
| P S Y C H I A T R Y | NY | |
| Physician Assistant | FL | |
| Physician Assistant | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| - | FL | |
| Nurse Practitioner | FL |
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