MARLA SMITH JOHNSON (APRN) – Nurse Practitioner, NPI 1104821982
Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MARLA SMITH JOHNSON (APRN)
PO BOX 636324
CINCINNATI, OH 452636324
Phone: (859) 301-2000
Fax: (859) 301-6910
Type: Mailing
600 Wilson Creek Rd
Lawrenceburg, IN 470252751
Phone: (812) 496-4910
Fax: (812) 532-2664
Type: Location
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 410173403
Phone: (859) 301-2000
Fax: (859) 301-6910
Type: Location
Boom Box Buns, 1324, Main Street, Main Street Business District, Over-the-Rhine, Cincinnati, Hamilton County, Ohio, 45202, United States
CINCINNATI, OH 452635283
Phone: (859) 301-2000
Fax: (859) 301-6910
Type: Mailing
900, Medical Village Drive, Edgewood, Kenton County, Kentucky, 41017, United States
MEDI
EDGEWOOD, KY 41017
Phone: (859) 331-0774
Fax: (859) 578-3800
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 $36.
Total Amount is formed as General ($36) + Research ($0) + Ownership ($0) = $36.
Last reported payment date: 2023-01-25 • Largest payer in this snapshot: W. L. Gore & Associates, Inc. ($36).
Total Amount
$36
General + Research + Ownership
Payments
1
Total payment records
General Amount
$36
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-01-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| W. L. Gore & Associates, Inc. | $36 |
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: 2024-07-24
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090402000506 | I | Nurse Practitioner | KY | TBD |
| I20240724000186 | I | Nurse Practitioner | IN | 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 45263)
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