DAVID E JOHNSON (ANP) – Nurse Practitioner, NPI 1477742047
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,637 NURSE PRACTITIONER in IL
Provider Addresses for DAVID E JOHNSON (ANP)
2090 UADALABENE DRIVE
MARYVILLE, IL 62062
Phone: (618) 288-5430
Fax: (618) 288-6857
Type: Location
6810 STATE ROUTE 162 BOX 215
MARYVILLE, IL 620628501
Phone: (618) 391-6405
Fax: (618) 288-4088
Type: Mailing
2090 Uadalabene Drive
Maryville, IL 62062
Phone: (618) 288-5430
Fax: (618) 288-6857
Type: Location
6812 STATE ROUTE 162 STE 21
MARYVILLE, IL 620628565
Phone: (618) 288-5566
Fax: (618) 288-4005
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $112.
Total Amount is formed as General ($112) + Research ($0) + Ownership ($0) = $112.
Last reported payment date: 2024-10-01 • Largest payer in this snapshot: Abbott Laboratories ($68).
Total Amount
$112
General + Research + Ownership
Payments
6
Total payment records
General Amount
$112
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-01
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $68 |
| ABBVIE INC. | $26 |
| Lilly USA, LLC | $18 |
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: 2007-10-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-10-31 (956 days ago).
Enrollment records
1
Earliest due date
2023-10-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20071025000520 | I | Nurse Practitioner | IL | 2023-10-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 251 | 196 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 218 | 163 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 36 | 36 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 20 | 19 | $0 |
| 69209 | Removal of impacted ear wax by washing | 15 | 14 | $0 |
Insurance plans in this area (ZIP 62062)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| - | IL | |
| General Surgery | IL | |
| - | IL | |
| - | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| General Surgery | IL | |
| - | IL | |
| Family Practice | MO | |
| Family Practice | IL |
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