AUDRA JOHNSON – Clinical Social Worker, NPI 1124629696

AUDRA JOHNSON is a healthcare provider. based in Cortland, Illinois. specializing in CLINICAL SOCIAL WORKER. They hold a License No. 149.025033 (IL). The NPI Number for AUDRA JOHNSON is 1124629696

Main info

Female
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
AUDRA JOHNSON
NPI
1124629696
Phone
Not provided
Address
PO BOX 107
Enumeration Date
2 November 2020
Last Update Date
1 May 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6303941379
Graduation Year
2020 (6 years ago)
PAC ID
9234645813
Group Practice PAC ID
5193171346
Professional Enrollment ID
I20250721003178
Address ID
IL605061460AU1315XAVEX403
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness85
Years active:5State licenses:1Digital endpointsOther names

3,510 CLINICAL SOCIAL WORKER in IL

Provider Addresses for AUDRA JOHNSON

  • PO BOX 107

    CORTLAND, IL 601120107

    Phone:

    Type: Mailing

  • 1813 N MILL ST STE F

    NAPERVILLE, IL 605634872

    Phone: (630) 536-8073

    Type: Location

  • 1020 E OGDEN AVE STE 204

    NAPERVILLE, IL 605638610

    Phone: (847) 942-2512

    Type: Location

  • 1315 N HIGHLAND AVE STE 202

    AURORA, IL 605061460

    Phone: (630) 394-1379

    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: 2025-07-21

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
I20250721003178IClinical Social WorkerILTBD

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 60112)

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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: 5193171346View full group profile
NameSpecialtyState
Clinical Social WorkerIL
Clinical Social WorkerIL
Mental Health CounselorIL
Clinical Social WorkerIL

Reviews

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Frequently asked questions

Where can patients find AUDRA JOHNSON's NPI?
You can confirm AUDRA JOHNSON with NPI 1124629696; it appears in the national provider directory.
Is AUDRA JOHNSON's NPI currently valid?
The extract we use shows AUDRA JOHNSON as active.
Can you summarize AUDRA JOHNSON's specialty in plain language?
Clinically, the directory lists AUDRA JOHNSON with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What location shows for AUDRA JOHNSON?
We surface Cortland, Illinois for AUDRA JOHNSON based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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