GLADYS B JOHNSON – Family Nurse Practitioner, NPI 1407458102

GLADYS B JOHNSON is a healthcare provider. based in Stone mountain, Georgia. specializing in NURSE PRACTITIONER. They hold a License No. RN163718 (GA). The NPI Number for GLADYS B JOHNSON is 1407458102

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
GLADYS B JOHNSON
NPI
1407458102
Phone
(404) 376-2876
Address
3962 CARLINSWOOD WAY
Enumeration Date
9 November 2020
Last Update Date
9 November 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6784568463
Graduation Year
2019 (7 years ago)
PAC ID
9739593013
Group Practice PAC ID
2163667643
Professional Enrollment ID
I20210201000944
Address ID
GA300416239CU4415XDRXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

9,658 NURSE PRACTITIONER in GA

Provider Addresses for GLADYS B JOHNSON

  • 3962 CARLINSWOOD WAY

    STONE MOUNTAIN, GA 300834776

    Phone: (404) 376-2876

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2021-02-01

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210201000944INurse PractitionerGATBD

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.

Verify on CMS Revalidation Lookup Tool

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 30083)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163667643View full group profile
NameSpecialtyState
Nurse PractitionerGA
Internal MedicineGA

Reviews

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Frequently asked questions

What identifier follows GLADYS B JOHNSON across health systems?
The NPI 1407458102 uniquely identifies GLADYS B JOHNSON in U.S. healthcare data.
Quick check: is GLADYS B JOHNSON active?
Public NPPES data shows GLADYS B JOHNSON with an active NPI status right now.
What type of care does GLADYS B JOHNSON provide?
GLADYS B JOHNSON's profile centers on Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What geographic area is tied to GLADYS B JOHNSON?
GLADYS B JOHNSON is associated with Stone Mountain, Georgia in the same public data insurers reference.
Why is information missing for GLADYS B JOHNSON?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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