KIMBERLY L JOHNSON (ARNP) – Family Nurse Practitioner, NPI 1073849410
Family Nurse Practitioner
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for KIMBERLY L JOHNSON (ARNP)
421, Liberty Lane, Evesham Township, Burlington County, New Jersey, 08053-5344, United States
LIBERTY LAKE, WA 990190421
Phone: (509) 474-4060
Fax: (509) 227-7070
Type: Mailing
Providence Sacred Heart Medical Center and Children's Hospital, 101, West 8th Avenue, Spokane, Spokane County, Washington, 99204, United States
SUITE 1100
SPOKANE, WA 992042307
Phone: (509) 474-4060
Fax: (509) 474-6198
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 $15.
Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.
Last reported payment date: 2024-01-30 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($15).
Total Amount
$15
General + Research + Ownership
Payments
1
Total payment records
General Amount
$15
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-01-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Merck Sharp & Dohme LLC | $15 |
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: 2009-12-15
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 |
|---|---|---|---|---|
| I20091215000675 | I | Nurse Practitioner | WA | 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 99019)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WA | |
| Internal Medicine | WA | |
| - | WA | |
| Physician Assistant | WA | |
| - | WA | |
| - | WA | |
| Physician Assistant | WA | |
| Internal Medicine | WA | |
| - | WA | |
| - | WA |
Reviews
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