Elizabeth Johnson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2011040126 Issued in MO

Practice address

1111 W Pearce Blvd
Wentzville, MO 63385-1020

Phone

(636) 887-3020

Fax

(636) 887-3022

NPI assigned

Jan 6, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  MO

  Medicare reassignment NPD
• Our Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Maryland Heights, MO
  • NPI 1871819680
  NPD (past)

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1073883146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 RIDGEWAY AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631144546",
            "telephone_number": "314-938-4438",
            "fax_number": "314-938-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W PEARCE BLVD",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633851020",
            "telephone_number": "636-887-3020",
            "fax_number": "636-887-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ELIZABETH",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-06",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2011040126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Jenkins, LCSW
• Jennifer Blei, D.C., LLC
• Laura L Jennings, RPH
• Diane Marie Jessen, O.D.
• Nathan M Johannsson, DDS
• Ellen Johnson, M.S. , CCC-SLP
• Gregory M Johnson, DDS
• Marcia Michelle Johnson
• Summer Danielle Johnson, PSY.D.
• Braden S Johnston, LPC

• Family Nurse Practitioner in Wentzville, MO
• Providers in Wentzville, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.