DR. WILLIAM BECK JOHANSEN (MD) – Pediatrics Physician, NPI 1073975132
Pediatrics Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
68 HOSPICE/PALLIATIVE CARE in KY
Provider Addresses for DR. WILLIAM BECK JOHANSEN (MD)
6200 Dutchmans Ln
Louisville, KY 402053271
Phone: (502) 456-6200
Fax: (502) 456-6655
Type: Location
Saint Louis Childrens Hospital School, 1, Children's Place, Central West End, City of Saint Louis, Missouri, 63110, United States
MS 8515-87-1200
SAINT LOUIS, MO 631103818
Phone: (314) 273-1006
Type: Mailing
6200 DUTCHMANS LN
LOUISVILLE, KY 402053271
Phone: (502) 456-6200
Fax: (024) 566-6555
Type: Mailing
1 CHILDRENS PL
MSC 8515-87-1200
SAINT LOUIS, MO 631101002
Phone: (314) 454-2683
Fax: (314) 454-4633
Type: Mailing
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: 2025-07-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20200831002185 | I | Pediatric Medicine | MO | TBD |
| I20250604000511 | I | Pediatric Medicine | IN | TBD |
| I20250703001682 | I | Pediatric Medicine | KY | 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 40205)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | KY | |
| Nurse Practitioner | NC | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| - | KY | |
| Geriatric Medicine, Hospice/Palliative Care, Geriatric Medicine, Internal Medicine | NC | |
| Nurse Practitioner | KY | |
| Clinical Social Worker | KY | |
| Clinical Social Worker | KY |
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