DR. DONNA SUE JOHNSON (OD) – Optometrist, NPI 1174565378

DR. DONNA SUE JOHNSON (OD) is a healthcare provider. based in Centralia, Illinois. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 046007821 (IL). The NPI Number for DR. DONNA SUE JOHNSON (OD) is 1174565378

Main info

Female
Sole Proprietor
41 Years Of Experience
Accepts Medicare Assignment
Name
DR. DONNA SUE JOHNSON (OD)
NPI
1174565378
Phone
(618) 533-4929
Address
418 S POPLAR
Enumeration Date
12 June 2006
Last Update Date
12 August 2008

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
-
Graduation Year
1985 (41 years ago)
PAC ID
1850449596
Professional Enrollment ID
I20090506000378
Address ID
IL628013940CE418XXSTXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,715 OPTOMETRY in IL

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Provider Addresses for DR. DONNA SUE JOHNSON (OD)

  • 418, South Poplar Street, Wamac, Centralia, Marion County, Illinois, 62801, United States

    SUITE 5

    CENTRALIA, IL 62801

    Phone: (618) 533-4929

    Fax: (618) 533-4929

    Mailing address matches the actual address.

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: 2009-05-06

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
I20090506000378IOptometryILTBD

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
92014Established patient complete exam of visual system4141$0
92250Photography of the retina4036$0
View full utilization report →

Insurance plans in this area (ZIP 62801)

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Reviews

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Frequently asked questions

What is the standard ID for DR. DONNA SUE JOHNSON (OD) in the U.S.?
In the U.S., DR. DONNA SUE JOHNSON (OD) is identified by NPI 1174565378.
Quick check: is DR. DONNA SUE JOHNSON (OD) active?
Public NPPES data shows DR. DONNA SUE JOHNSON (OD) with an active NPI status right now.
What type of care does DR. DONNA SUE JOHNSON (OD) provide?
DR. DONNA SUE JOHNSON (OD)'s profile centers on Optometrist. Clinical services aligned with this taxonomy classification.
Which community is linked to DR. DONNA SUE JOHNSON (OD)?
DR. DONNA SUE JOHNSON (OD) shows a connection to Centralia, Illinois in registry-derived data.
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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