DEDRA JOHNSON – Family Nurse Practitioner, NPI 1225621154

DEDRA JOHNSON is a healthcare provider. based in Richmond, Texas. specializing in NURSE PRACTITIONER. They hold a License No. 79468 (NM). The NPI Number for DEDRA JOHNSON is 1225621154

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
DEDRA JOHNSON
NPI
1225621154
Phone
(716) 444-2537
Address
8554 RUBY RIVER LN
Enumeration Date
11 February 2021
Last Update Date
22 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5054133719
Graduation Year
2019 (7 years ago)
PAC ID
2860898145
Group Practice PAC ID
5799143103
Professional Enrollment ID
I20250407003836
Address ID
NM87110XXXXALXXXXXXXXXX00
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:5State licenses:3Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for DEDRA JOHNSON

  • 8554 RUBY RIVER LN

    RICHMOND, TX 774072580

    Phone: (716) 444-2537

    Mailing address matches the actual address.

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: 2025-04-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20210913000710INurse PractitionerTXTBD
I20250407003836INurse PractitionerNMTBD

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 77407)

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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: 5799143103View full group profile
NameSpecialtyState
Internal MedicineTN
Nurse PractitionerNM
Nurse PractitionerAL
Nurse PractitionerNM
Nurse PractitionerNM
Nurse PractitionerWA
Nurse PractitionerTX
Nurse PractitionerTX
General PracticeCA
Nurse PractitionerNM

Reviews

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Frequently asked questions

How do payers reference DEDRA JOHNSON?
For DEDRA JOHNSON, use NPI 1225621154 as the unique 10-digit identifier.
Would DEDRA JOHNSON appear as active to a payer?
You can treat DEDRA JOHNSON as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to DEDRA JOHNSON?
DEDRA JOHNSON's specialty line reads Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with DEDRA JOHNSON?
Directory geography for DEDRA JOHNSON centers on Richmond, Texas.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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