MICHAEL J JOHNSON – Psychiatric/Mental Health Nurse Practitioner, NPI 1104175405

MICHAEL J JOHNSON is a healthcare provider. based in Davenport, Iowa. specializing in Psychiatric/Mental Health Nurse Practitioner. They hold a License No. 209009740 (IL). The NPI Number for MICHAEL J JOHNSON is 1104175405

Main info

Male
Name
MICHAEL J JOHNSON
NPI
1104175405
Phone
(563) 332-8528
Address
2826 W LOCUST ST
Enumeration Date
31 August 2012
Last Update Date
29 September 2020
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:13State licenses:2Digital endpointsOther names

Provider Addresses for MICHAEL J JOHNSON

  • 2826 W LOCUST ST

    DAVENPORT, IA 528043354

    Phone: (563) 332-8528

    Type: Mailing

  • 1026 A AVE NE

    CEDAR RAPIDS, IA 524025036

    Phone: (319) 369-7959

    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: 2015-05-04

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
I20150504002270INurse PractitionerIATBD

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 52804)

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Reviews

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Frequently asked questions

How is MICHAEL J JOHNSON identified in CMS data?
CMS-hosted NPPES data lists MICHAEL J JOHNSON with NPI 1104175405.
Can I rely on MICHAEL J JOHNSON being an active provider?
As of the registry snapshot, MICHAEL J JOHNSON is marked active.
What is MICHAEL J JOHNSON's primary classification?
Psychiatric/Mental Health Nurse Practitioner is the headline specialty for MICHAEL J JOHNSON here. Clinical services aligned with this taxonomy classification.
Does MICHAEL J JOHNSON list a practice location?
Patients near Davenport, Iowa may find MICHAEL J JOHNSON in results; validate coverage separately.
Is the information about MICHAEL J JOHNSON up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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