GREG R JOHNSON (DO) – Nephrology Physician, NPI 1013960269
Nephrology Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for GREG R JOHNSON (DO)
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 468451701
Phone:
Type: Mailing
3909 NEW VISION DR
FORT WAYNE, IN 468451725
Phone: (260) 469-6602
Fax: (260) 969-3065
Type: Location
1234, East Dupont Road, Fort Wayne, Allen County, Indiana, 46825, United States
SUITE 1
FORT WAYNE, IN 468251545
Phone: (260) 373-9700
Fax: (260) 373-9740
Type: Mailing
1900, Carew Street, Fort Wayne, Allen County, Indiana, 46805, United States
SUITE 3A
FORT WAYNE, IN 468054765
Phone: (260) 373-9919
Fax: (260) 373-6315
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $25.
Total Amount is formed as General ($25) + Research ($0) + Ownership ($0) = $25.
Last reported payment date: 2024-07-16 • Largest payer in this snapshot: IDORSIA PHARMACEUTICALS US INC ($25).
Total Amount
$25
General + Research + Ownership
Payments
1
Total payment records
General Amount
$25
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| IDORSIA PHARMACEUTICALS US INC | $25 |
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: 2010-09-28
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 |
|---|---|---|---|---|
| I20100928001695 | I | Internal Medicine | IN | 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 46845)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IN | |
| Nurse Practitioner | NM | |
| - | IN | |
| Nurse Practitioner | IN | |
| Family Practice | IN | |
| - | IN | |
| - | IN | |
| Infectious Disease | IN | |
| Internal Medicine | IN | |
| - | IN |
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