Individual provider Active NPI

Cynthia Elaine Johnson, FNP

  • Acute Care Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1154816700
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2018006692 Issued in MO
Practice address
11133 Dunn Rd
Dept Anesthesiology
Saint Louis, MO 63136-6163
Phone
(800) 862-9980
Fax
(314) 362-1185
NPI assigned
Jun 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2018006692 MO Primary

Addresses

Primary practice location

11133 Dunn Rd
Dept Anesthesiology
Saint Louis, MO 63136-6163

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (800) 862-9980

Other identifiers 1

IdentifierTypeStateIssuer
420056116MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180716001170 MO Practitioner - Nurse Practitioner 2961759493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri St Louis - School of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Phone (314) 747-3000

11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone (314) 653-5000

Hospital & facility affiliations

  • Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2018006692MOMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Jun 9, 2018 Accepting new patients
Washington University CurrentSince Jun 9, 2018 Accepting new patients
Washington University PastSince Nov 16, 2021 Accepting new patients

Locations

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

660 S Euclid Ave
#8054
Saint Louis, MO 63110
Phone (314) 286-1045

1 Barnes Hsp Plz
Saint Louis, MO 63110
Phone (314) 273-4966

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

Organizations & group practices 3

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 2

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": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1154816700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "800-862-9980",
            "fax_number": "314-362-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11133 DUNN RD",
            "address_2": "DEPT ANESTHESIOLOGY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366163",
            "telephone_number": "800-862-9980",
            "fax_number": "314-362-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CYNTHIA",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2018006692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420056116",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "11133 Dunn Rd",
            "address_2": "Dept Anesthesiology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631366163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.