KERRY A JOHNSON (CNP-FNP-DNP) – Family Nurse Practitioner, NPI 1477504058
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for KERRY A JOHNSON (CNP-FNP-DNP)
2004 Randolph Ave
Whitby Hall #431
Saint Paul, MN 551051750
Phone: (651) 690-6714
Type: Location
Chicago Av, Washington Avenue South, Minneapolis, Hennepin County, Minnesota, 55415:55454, United States
MINNEAPOLIS, MN 554071321
Phone: (612) 262-5000
Type: Mailing
Nicollet Av, County Road 42 West, Burnsville, Dakota County, Minnesota, 55306, United States
BURNSVILLE, MN 553375793
Phone: (952) 428-0200
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $5,255.
Total Amount is formed as General ($5,255) + Research ($0) + Ownership ($0) = $5,255.
Last reported payment date: 2024-07-29 • Largest payer in this snapshot: Organon LLC ($5,225).
Total Amount
$5,255
General + Research + Ownership
Payments
7
Total payment records
General Amount
$5,255
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Organon LLC | $5,225 |
| Ethicon US, LLC | $17 |
| AstraZeneca Pharmaceuticals LP | $14 |
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: 2006-10-06
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 |
|---|---|---|---|---|
| I20061006000426 | I | Nurse Practitioner | MN | 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 55105)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pulmonary Disease | CO | |
| Qualified Audiologist | MN | |
| Family Practice | MN | |
| - | MN | |
| Family Practice | MN | |
| Nurse Practitioner | ND | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN |
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