MS. MOIS A JOHNSON (NP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1083993273
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for MS. MOIS A JOHNSON (NP)
2300 N EDWARD ST
GSBLL
DECATUR, IL 625264163
Phone: (217) 876-2857
Fax: (217) 876-2874
Type: Mailing
3131 N WATER ST
DECATUR, IL 625262472
Phone: (217) 876-5320
Fax: (217) 876-5865
Type: Location
2301 E 20TH ST UNIT 6687
FARMINGTON, NM 874997231
Phone: (505) 800-7335
Fax: (505) 333-0444
Type: Mailing
203 W MAIN ST
FARMINGTON, NM 874016244
Phone: (505) 517-4181
Fax: (505) 333-0444
Type: Location
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: 2024-05-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20110926000199 | I | Nurse Practitioner | IL | TBD |
| I20170607002838 | I | Nurse Practitioner | TX | TBD |
| I20190129003129 | I | Nurse Practitioner | NM | TBD |
| I20240522001823 | I | Nurse Practitioner | WA | 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 62526)
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