ANDREA K JOHNSON (MD) – Family Medicine Physician, NPI 1477545192

ANDREA K JOHNSON (MD) is a healthcare provider. based in Liberty lake, Washington. specializing in Family Medicine Physician. They hold the professional credentials MD. They hold a License No. MD00038939 (WA). The NPI Number for ANDREA K JOHNSON (MD) is 1477545192

Main info

Female
Sole Proprietor
28 Years Of Experience
Accepts Medicare Assignment
Name
ANDREA K JOHNSON (MD)
NPI
1477545192
Phone
(866) 747-2455
Address
PO BOX 421
Enumeration Date
18 August 2005
Last Update Date
19 May 2021

Doctor Profile

Medical School Name
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Secondary Phone
5096843701
Graduation Year
1998 (28 years ago)
PAC ID
3274513759
Group Practice PAC ID
0345139929
Professional Enrollment ID
I20040723001140

Contacts

Secure Messaging
ajohnson221663@wm.providencedirect.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

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Provider Addresses for ANDREA K JOHNSON (MD)

  • 421, Liberty Lane, Evesham Township, Burlington County, New Jersey, 08053-5344, United States

    LIBERTY LAKE, WA 990190421

    Phone: (866) 747-2455

    Fax: (509) 227-7070

    Type: Mailing

  • 551, East Hawthorne Road, Country Homes, Spokane County, Washington, 99218, United States

    SPOKANE, WA 992181417

    Phone: (509) 252-1900

    Fax: (509) 227-7070

    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: 2004-07-23

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
I20040723001140IFamily PracticeWATBD

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 99019)

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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: 0345139929View full group profile

Reviews

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Frequently asked questions

How do payers reference ANDREA K JOHNSON (MD)?
For ANDREA K JOHNSON (MD), use NPI 1477545192 as the unique 10-digit identifier.
Is ANDREA K JOHNSON (MD) still an active registrant?
ANDREA K JOHNSON (MD) carries an active NPI according to the public dataset.
What kind of doctor is ANDREA K JOHNSON (MD)?
ANDREA K JOHNSON (MD) is associated with Family Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with ANDREA K JOHNSON (MD)?
Directory geography for ANDREA K JOHNSON (MD) centers on Liberty Lake, Washington.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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