STACY L JOHNSON (FNP-C) – Psychiatric/Mental Health Nurse Practitioner, NPI 1174002232
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,017 NURSE PRACTITIONER in MO
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Provider Addresses for STACY L JOHNSON (FNP-C)
751 JONATHAN CODY DR
WENTZVILLE, MO 633856877
Phone: (314) 608-5726
Fax: (314) 842-2552
Type: Mailing
Medical Drive, Hannibal, Marion County, Missouri, United States
HANNIBAL, MO 634016877
Phone: (573) 221-5250
Type: Mailing
2650 OLIVE ST
SAINT LOUIS, MO 631031489
Phone: (314) 802-2647
Fax: (314) 842-2552
Type: Mailing
255 SPENCER RD STE 201
SAINT PETERS, MO 633762576
Phone: (636) 939-2550
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 37 Open Payments records for all available years, with a total value of $622.
Total Amount is formed as General ($622) + Research ($0) + Ownership ($0) = $622.
Last reported payment date: 2024-06-25 • Largest payer in this snapshot: ABBVIE INC. ($237).
Total Amount
$622
General + Research + Ownership
Payments
37
Total payment records
General Amount
$622
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $237 |
| Otsuka America Pharmaceutical, Inc. | $118 |
| Teva Pharmaceuticals USA, Inc. | $81 |
| ITI, Inc. | $40 |
| Alkermes, Inc. | $36 |
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: 2018-10-08
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 |
|---|---|---|---|---|
| I20181008001380 | I | Nurse Practitioner | MO | 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 63385)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | MI | |
| Nurse Practitioner | OH | |
| - | OH | |
| - | IN | |
| - | KS | |
| Clinical Social Worker | FL | |
| P S Y C H I A T R Y | OH | |
| Mental Health Counselor | OH | |
| Mental Health Counselor | OH | |
| - | OH |
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