MIKA LYNN JOHNSON (APRN, CNP) – Gerontology Nurse Practitioner, NPI 1063846467

MIKA LYNN JOHNSON (APRN, CNP) is a healthcare provider. based in Pekin, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN, CNP. They hold a License No. 209015838 (IL). The NPI Number for MIKA LYNN JOHNSON (APRN, CNP) is 1063846467

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
MIKA LYNN JOHNSON (APRN, CNP)
NPI
1063846467
Phone
(336) 909-4907
Address
1900 PRIMROSE ST
Enumeration Date
21 August 2013
Last Update Date
23 August 2024

Doctor Profile

Medical School Name
DUKE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
8157962267
Graduation Year
2013 (13 years ago)
PAC ID
8022244797
Group Practice PAC ID
6002090933
Professional Enrollment ID
I20170615000706
Address ID
IL617409108FL201XXHWYX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:12State licenses:2Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for MIKA LYNN JOHNSON (APRN, CNP)

  • 1900 PRIMROSE ST

    PEKIN, IL 615549584

    Phone: (336) 909-4907

    Type: Mailing

  • 221 NE GLEN OAK AVE

    PEORIA, IL 616360001

    Phone: (309) 672-5522

    Type: Location

  • 3333 W DeYoung St

    Marion, IL 629595884

    Phone: (618) 998-7000

    Type: Location

  • 1401 E State St

    Rockford, IL 611042315

    Phone: (779) 696-4400

    Type: Location

  • 1051 W SOUTH ST

    KEWANEE, IL 614438354

    Phone: (815) 454-2811

    Fax: (815) 454-2832

    Type: Mailing

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: 2023-03-17 • Largest payer in this snapshot: ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) ($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

2023-03-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2017-06-15

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
I20170615000706INurse PractitionerILTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99239Hospital discharge day management, more than 30 minutes7369$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes6945$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes6043$0
99284Emergency department visit with moderate level of medical decision making4242$0
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes4221$0
View full utilization report →

Insurance plans in this area (ZIP 61554)

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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: 6002090933View full group profile
NameSpecialtyState
Nurse PractitionerIL
Nurse PractitionerIL
P S Y C H I A T R YIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Physician AssistantIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

Does MIKA LYNN JOHNSON (APRN, CNP) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MIKA LYNN JOHNSON (APRN, CNP) uses 1063846467.
Can I rely on MIKA LYNN JOHNSON (APRN, CNP) being an active provider?
As of the registry snapshot, MIKA LYNN JOHNSON (APRN, CNP) is marked active.
What taxonomy line describes MIKA LYNN JOHNSON (APRN, CNP)?
For research purposes, treat MIKA LYNN JOHNSON (APRN, CNP) as Gerontology Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Does MIKA LYNN JOHNSON (APRN, CNP) list a practice location?
Patients near Pekin, Illinois may find MIKA LYNN JOHNSON (APRN, CNP) in results; validate coverage separately.
Why does MIKA LYNN JOHNSON (APRN, CNP) have multiple addresses?
6 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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