Individual provider Active NPI

Christopher Reavis Johnson, M.D.

  • Family Medicine Physician
  • Morton, IL
National Provider Identifier
1043445869
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-131984 Issued in IL
Practice address
621 W Jackson St
Morton, IL 61550-1535
Phone
(309) 938-4067
NPI assigned
May 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-131984 IL Primary

Addresses

Primary practice location

621 W Jackson St
Morton, IL 61550-1535

Mailing address

PO Box 19248
Springfield, IL 62794-9248
Phone (217) 528-7541

Other identifiers 1

IdentifierTypeStateIssuer
036131984MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130807000311 IL Practitioner - Family PracticePractitioner - Sports Medicine 5294903373 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians

Practice addresses (Care Compare)

134 W Adams St
Morton, IL 61550-1802
Phone (309) 291-3380

775 Engineering Ave
Springfield, IL 62703-5909
Phone (217) 522-4300

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
  • Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209
  • Carle Health Pekin Hospital Hospital, Pekin, IL, CCN 140120
  • Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-131984ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Community Health Clinic CurrentSince Feb 19, 2024 Accepting new patients
Heartland Community Health Clinic Current Accepting new patients
Springfield Clinic, LLP CurrentSince Nov 4, 2024 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

621 W Jackson St
Morton, IL 61550
Phone (309) 263-4343

2214 N University St
Peoria, IL 61604

1701 W Garden St
Peoria, IL 61605

2321 N Wisconsin Ave
Peoria, IL 61603
Phone (309) 688-9456

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

Interoperability endpoints

  • Direct secure messaging: christopher.johnson.1@28977.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1043445869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W JACKSON ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501535",
            "telephone_number": "309-938-4067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "REAVIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-22",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-131984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036131984",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton, IL

Sources for this page

Verify at the official NPI Registry.