KAITLYN ANN JOHNSON (FNP-C) – Family Nurse Practitioner, NPI 1184440794

KAITLYN ANN JOHNSON (FNP-C) is a healthcare provider. based in Allendale, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 209030912 (IL). The NPI Number for KAITLYN ANN JOHNSON (FNP-C) is 1184440794

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
KAITLYN ANN JOHNSON (FNP-C)
NPI
1184440794
Phone
(618) 553-4488
Address
PO BOX 145
Enumeration Date
27 November 2024
Last Update Date
27 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2022 (4 years ago)
PAC ID
8022530070
Group Practice PAC ID
8022908185
Professional Enrollment ID
I20250319001314
Address ID
IL628632638MT1418XDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for KAITLYN ANN JOHNSON (FNP-C)

  • PO BOX 145

    ALLENDALE, IL 624100145

    Phone: (618) 553-4488

    Type: Mailing

  • 1418 COLLEGE DR

    MOUNT CARMEL, IL 628632638

    Phone: (618) 553-4488

    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: 2025-03-19

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
I20250319001314INurse 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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62410)

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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: 8022908185View full group profile
NameSpecialtyState
Family PracticeNM
Nurse PractitionerIL
Nurse PractitionerIL
General SurgeryIN
Nurse PractitionerME
Nurse PractitionerIL
Family PracticeIL
-IN
Nurse PractitionerIL
General SurgeryTN

Reviews

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Frequently asked questions

What NPI should I save for KAITLYN ANN JOHNSON (FNP-C)?
Save NPI 1184440794 if you need a stable reference for KAITLYN ANN JOHNSON (FNP-C).
Does this profile mean KAITLYN ANN JOHNSON (FNP-C) is currently active?
Yes — KAITLYN ANN JOHNSON (FNP-C) appears active in the national provider directory.
What field does KAITLYN ANN JOHNSON (FNP-C) work in?
You can think of KAITLYN ANN JOHNSON (FNP-C) as practicing within Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where does public data place KAITLYN ANN JOHNSON (FNP-C)?
The snapshot lists Allendale, Illinois for KAITLYN ANN JOHNSON (FNP-C); download NPPES for the complete set.
What if Allendale, Illinois seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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