TERESA JOHNSON (APRN) – Nurse Practitioner, NPI 1639690191
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
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Provider Addresses for TERESA JOHNSON (APRN)
1685 BOSKYDELL RD
CARBONDALE, IL 629027808
Phone: (618) 292-9867
Type: Mailing
1101, Diann Lane, Carbondale, Jackson County, Illinois, 62901, United States
CARBONDALE, IL 629015339
Phone: (618) 997-6800
Fax: (618) 457-0211
Type: Location
7 S Hospital Dr
Murphysboro, IL 629663333
Phone: (161) 851-9920
Fax: (618) 684-2478
Type: Location
109 CALIFORNIA ST, PO BOX 577
CARTERVILLE, IL 629180577
Phone: (161) 851-9920
Fax: (618) 985-4635
Type: Mailing
1006 S DIVISION ST
CARTERVILLE, IL 629181539
Phone: (618) 519-9200
Fax: (618) 985-3774
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 114 Open Payments records for all available years, with a total value of $2,404.
Total Amount is formed as General ($2,404) + Research ($0) + Ownership ($0) = $2,404.
Last reported payment date: 2024-12-31 • Largest payer in this snapshot: ABBVIE INC. ($550).
Total Amount
$2,404
General + Research + Ownership
Payments
114
Total payment records
General Amount
$2,404
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $550 |
| AstraZeneca Pharmaceuticals LP | $269 |
| PFIZER INC. | $178 |
| Edwards Lifesciences Corporation | $130 |
| Lilly USA, LLC | $102 |
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: 2019-02-01
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190201001502 | I | Nurse Practitioner | IL | TBD |
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.
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 62902)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | NC | |
| Physician Assistant | NC | |
| Internal Medicine | SC | |
| Orthopedic Surgery | MO | |
| - | CA | |
| Physical Therapist In Private Practice | MD | |
| Physician Assistant | NC | |
| Internal Medicine | TN | |
| Nurse Practitioner | AR | |
| - | CO |
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