JESSICA MARIE JOHNSON – Nurse Practitioner, NPI 1114566379

JESSICA MARIE JOHNSON is a healthcare provider. based in Valparaiso, Indiana. specializing in NURSE PRACTITIONER. They hold a License No. 71009677A (IN). The NPI Number for JESSICA MARIE JOHNSON is 1114566379

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA MARIE JOHNSON
NPI
1114566379
Phone
Not provided
Address
85 E US HIGHWAY 6
Enumeration Date
4 January 2020
Last Update Date
16 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2199838300
Graduation Year
2019 (7 years ago)
PAC ID
9133550361
Group Practice PAC ID
6507808946
Professional Enrollment ID
I20200504000658
Address ID
IN463838947VA85XXX6XXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness85
Years active:6State licenses:1Digital endpointsOther names

8,192 NURSE PRACTITIONER in IN

Provider Addresses for JESSICA MARIE JOHNSON

  • 85 E US HIGHWAY 6

    VALPARAISO, IN 463838947

    Phone:

    Mailing address matches the actual address.

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: 2020-05-04

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
I20200504000658INurse PractitionerINTBD

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
99284Emergency department visit with moderate level of medical decision making8079$0
99285Emergency department visit with high level of medical decision making5454$0
99283Emergency department visit with low level of medical decision making1818$0
View full utilization report →

Insurance plans in this area (ZIP 46383)

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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: 6507808946View full group profile
NameSpecialtyState
Nurse PractitionerMI
Nurse PractitionerMA
-IN
Nurse PractitionerIN
Nurse PractitionerIN

Reviews

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Frequently asked questions

What NPI should I save for JESSICA MARIE JOHNSON?
Save NPI 1114566379 if you need a stable reference for JESSICA MARIE JOHNSON.
Is JESSICA MARIE JOHNSON active in the national directory?
JESSICA MARIE JOHNSON's public NPI profile is in an active state.
What kind of provider is JESSICA MARIE JOHNSON?
The page reflects Nurse Practitioner for JESSICA MARIE JOHNSON. Clinical services aligned with this taxonomy classification.
Where is JESSICA MARIE JOHNSON's primary listing?
We display Valparaiso, Indiana because that is what the record indicates for JESSICA MARIE JOHNSON.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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