AMANDA JOHNSON (AGACNP) – Acute Care Nurse Practitioner, NPI 1245052117

AMANDA JOHNSON (AGACNP) is a healthcare provider. based in Fenton, Missouri. specializing in NURSE PRACTITIONER. They hold the professional credentials AGACNP. They hold a License No. 2024013896 (MO). The NPI Number for AMANDA JOHNSON (AGACNP) is 1245052117

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA JOHNSON (AGACNP)
NPI
1245052117
Phone
Not provided
Address
1065 TIMBERLINE DR
Enumeration Date
30 October 2024
Last Update Date
30 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3144341500
Graduation Year
2023 (3 years ago)
PAC ID
7810424405
Group Practice PAC ID
1557366960
Professional Enrollment ID
I20241220000248
Address ID
MO630173406CH232XXRDXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

7,017 NURSE PRACTITIONER in MO

Provider Addresses for AMANDA JOHNSON (AGACNP)

  • 1065 TIMBERLINE DR

    FENTON, MO 630264557

    Phone:

    Type: Mailing

  • 232 S WOODS MILL RD

    CHESTERFIELD, MO 630173485

    Phone: (314) 434-1500

    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 $21.

Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.

Last reported payment date: 2024-01-29 • Largest payer in this snapshot: Medtronic, Inc. ($21).

Total Amount

$21

General + Research + Ownership

Payments

1

Total payment records

General Amount

$21

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-29

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Medtronic, Inc.$21
View all Open Payments →|Open Payments Risk Radar →

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: 2024-12-20

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
I20241220000248INurse PractitionerMOTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63026)

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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: 1557366960View full group profile
NameSpecialtyState
Hospitalist, Internal MedicineMO
Internal MedicineMO
-MO
-MO
H O S P I T A L I S TMO
-MO
Internal MedicineMO
Pulmonary Disease, Critical Care (Intensivists), Internal MedicineMO
H O S P I T A L I S TMO
Internal MedicineMO

Reviews

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Frequently asked questions

Can I verify AMANDA JOHNSON (AGACNP) with an NPI only?
You can start verification with NPI 1245052117 for AMANDA JOHNSON (AGACNP), then check state licensing separately.
Can I rely on AMANDA JOHNSON (AGACNP) being an active provider?
As of the registry snapshot, AMANDA JOHNSON (AGACNP) is marked active.
What is AMANDA JOHNSON (AGACNP)'s primary classification?
Acute Care Nurse Practitioner is the headline specialty for AMANDA JOHNSON (AGACNP) here. Clinical services aligned with this taxonomy classification.
Does AMANDA JOHNSON (AGACNP) list a practice location?
Patients near Fenton, Missouri may find AMANDA JOHNSON (AGACNP) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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