HOLLY LYNN JOHNSON – Psychiatric/Mental Health Nurse Practitioner, NPI 1174115455

HOLLY LYNN JOHNSON is a healthcare provider. based in Chardon, Ohio. specializing in NURSE PRACTITIONER. They hold a License No. 0028213 (OH). The NPI Number for HOLLY LYNN JOHNSON is 1174115455

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
HOLLY LYNN JOHNSON
NPI
1174115455
Phone
(440) 221-9969
Address
10431 KILE RD
Enumeration Date
8 February 2021
Last Update Date
8 February 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4405633400
Graduation Year
2020 (6 years ago)
PAC ID
2961881032
Group Practice PAC ID
5890738405
Professional Enrollment ID
I20220620001988
Address ID
OH440840000RO2863XNXXX501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

14,984 NURSE PRACTITIONER in OH

Provider Addresses for HOLLY LYNN JOHNSON

  • 10431 KILE RD

    CHARDON, OH 440249582

    Phone: (440) 221-9969

    Type: Mailing

  • 8701 MENTOR AVE

    MENTOR, OH 440606103

    Phone: (440) 221-9969

    Type: Location

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: 2022-06-20

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
I20220620001988INurse PractitionerOHTBD

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
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes2112$0
View full utilization report →

Insurance plans in this area (ZIP 44024)

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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: 5890738405View full group profile
NameSpecialtyState
Internal MedicineOH
-OH
Nurse PractitionerOH
Physician AssistantOH
-OH
Physician AssistantOH
Nurse PractitionerOH
-OH
Pediatric Medicine, Addiction Medicine, Addiction MedicineOH
Addiction Medicine, AnesthesiologyOH

Reviews

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Frequently asked questions

What identifier follows HOLLY LYNN JOHNSON across health systems?
The NPI 1174115455 uniquely identifies HOLLY LYNN JOHNSON in U.S. healthcare data.
Does the public listing show HOLLY LYNN JOHNSON as active?
HOLLY LYNN JOHNSON's NPI record reflects an active status in NPPES.
What type of care does HOLLY LYNN JOHNSON provide?
HOLLY LYNN JOHNSON's profile centers on Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Can patients visit HOLLY LYNN JOHNSON in Chardon, Ohio?
For routing, start with Chardon, Ohio for HOLLY LYNN JOHNSON, then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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