ANDREA MARIE JOHNSON (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1316610256

ANDREA MARIE JOHNSON (PMHNP) is a healthcare provider. based in Centralia, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP. They hold a License No. 209.023676 (IL). The NPI Number for ANDREA MARIE JOHNSON (PMHNP) is 1316610256

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
ANDREA MARIE JOHNSON (PMHNP)
NPI
1316610256
Phone
(618) 214-1178
Address
1603 RUTH ANN DR
Enumeration Date
27 July 2021
Last Update Date
27 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6184365665
Graduation Year
2021 (5 years ago)
PAC ID
1153726872
Group Practice PAC ID
9234022567
Professional Enrollment ID
I20210818003310
Address ID
IL628013006CE444XXAVEX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for ANDREA MARIE JOHNSON (PMHNP)

  • 1603 RUTH ANN DR

    CENTRALIA, IL 628015913

    Phone: (618) 214-1178

    Type: Mailing

  • 444 N PLEASANT AVE

    CENTRALIA, IL 628013006

    Phone: (618) 436-5665

    Fax: (618) 436-8042

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 7 Open Payments records for all available years, with a total value of $257.

Total Amount is formed as General ($257) + Research ($0) + Ownership ($0) = $257.

Last reported payment date: 2024-09-11 • Largest payer in this snapshot: Regeneron Pharmaceuticals, Inc. ($133).

Total Amount

$257

General + Research + Ownership

Payments

7

Total payment records

General Amount

$257

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-11

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2021-08-18

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
I20210818003310INurse 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes278105$0
99215Established patient office or other outpatient visit, 40-54 minutes4134$0
99213Established patient office or other outpatient visit, 20-29 minutes1812$0
View full utilization report →

Insurance plans in this area (ZIP 62801)

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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: 9234022567View full group profile
NameSpecialtyState
Vascular SurgeryIL
P A T H O L O G YIL
Sleep Medicine, Pediatric MedicineMO
P O D I A T R YMO
Nurse PractitionerMO
Family PracticeMO
General SurgeryMO
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

How do payers reference ANDREA MARIE JOHNSON (PMHNP)?
For ANDREA MARIE JOHNSON (PMHNP), use NPI 1316610256 as the unique 10-digit identifier.
Is ANDREA MARIE JOHNSON (PMHNP) still an active registrant?
ANDREA MARIE JOHNSON (PMHNP) carries an active NPI according to the public dataset.
What clinical focus is listed for ANDREA MARIE JOHNSON (PMHNP)?
At a glance, ANDREA MARIE JOHNSON (PMHNP) is tied to Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for ANDREA MARIE JOHNSON (PMHNP)?
Travel planning: use Centralia, Illinois as the reference point for ANDREA MARIE JOHNSON (PMHNP), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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