ANITA L JOHNSON (AUD) – Audiologist, NPI 1104891043

ANITA L JOHNSON (AUD) is a healthcare provider. based in Gibson city, Illinois. specializing in QUALIFIED AUDIOLOGIST. They hold the professional credentials AUD. They hold a License No. LD00001206 (WA). The NPI Number for ANITA L JOHNSON (AUD) is 1104891043

Main info

Female
41 Years Of Experience
Accepts Medicare Assignment
Name
ANITA L JOHNSON (AUD)
NPI
1104891043
Phone
(217) 784-4251
Address
1120 N MELVIN ST
Enumeration Date
22 February 2006
Last Update Date
15 December 2023

Doctor Profile

Medical School Name
WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2177844251
Graduation Year
1985 (41 years ago)
PAC ID
7214064393
Group Practice PAC ID
5092703124
Professional Enrollment ID
I20230623002950
Address ID
IL609361477GI1120XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:20State licenses:2Digital endpointsOther names

401 QUALIFIED AUDIOLOGIST in IL

Provider Addresses for ANITA L JOHNSON (AUD)

  • 1120 N MELVIN ST

    GIBSON CITY, IL 609361477

    Phone: (217) 784-4251

    Type: Mailing

  • 1 DOCTORS PARK

    GIBSON CITY, IL 609362000

    Phone: (217) 784-2808

    Type: Location

  • Virginia Mason Hospital & Seattle Medical Center, 1100, 9th Avenue, Central Business District, First Hill, Seattle, King County, Washington, 98101, United States

    MS:M4-PFS

    SEATTLE, WA 981012756

    Phone: (206) 515-5811

    Type: Mailing

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: 2023-06-23

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
I20230623002950IQualified AudiologistILTBD

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 60936)

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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: 5092703124View full group profile

Reviews

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Frequently asked questions

What number should I use to identify ANITA L JOHNSON (AUD) for billing?
Administrative and clinical systems typically use NPI 1104891043 for ANITA L JOHNSON (AUD).
Does the public listing show ANITA L JOHNSON (AUD) as active?
ANITA L JOHNSON (AUD)'s NPI record reflects an active status in NPPES.
What services align with ANITA L JOHNSON (AUD)'s listing?
ANITA L JOHNSON (AUD)'s public classification highlights Audiologist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to ANITA L JOHNSON (AUD)?
ANITA L JOHNSON (AUD) is associated with Gibson City, Illinois in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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