MS. NICOLE A JOHNSON (PA-C) – Physician Assistant, NPI 1033250576
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for MS. NICOLE A JOHNSON (PA-C)
PO BOX 3988
CARBONDALE, IL 629023988
Phone: (618) 457-5200
Type: Mailing
8305 Express Drive
Suite C
Marion, IL 62959
Phone: (618) 993-0086
Fax: (618) 993-0088
Type: Location
2 S Hospital Dr
Murphysboro, IL 629663333
Phone: (618) 684-3156
Type: Location
201 S 14th St
Herrin, IL 629483631
Phone: (618) 942-2171
Type: Location
PO BOX 1433
MURPHYSBORO, IL 62966
Phone: (618) 993-0086
Fax: (618) 993-0088
Type: Mailing
8305 EXPRESS DRIVE
SUITE C
MARION, IL 62959
Phone: (618) 993-0086
Fax: (618) 993-0088
Type: Location
405 W JACKSON ST
CARBONDALE, IL 629011462
Phone: (618) 549-0721
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 $17.
Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.
Last reported payment date: 2023-02-10 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($17).
Total Amount
$17
General + Research + Ownership
Payments
1
Total payment records
General Amount
$17
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-02-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Pharmaceuticals, Inc | $17 |
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: 2008-06-03
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 |
|---|---|---|---|---|
| I20080603000148 | I | Physician Assistant | IL | 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 62902)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | GA | |
| Internal Medicine | NY | |
| - | GA | |
| Internal Medicine | SC | |
| - | KY | |
| H O S P I T A L I S T | SC | |
| Internal Medicine, Hospitalist | TN | |
| Internal Medicine, Hospitalist | SC | |
| Hospitalist, Family Practice, Family Practice | VA | |
| Internal Medicine | GA |
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