Michele Dawn Johnson, APN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

209.006878 Issued in IL

Practice address

3775 N Mulford Rd
Rockford, IL 61114-5632

Phone

(815) 636-6400

NPI assigned

Dec 17, 2007

Last updated

Nov 17, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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 IL

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

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saint Anthony Medical CenterGroup PAC ID 5496654006, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Healthcare Home Care Home health agency, Loves Park, IL, CCN 147271
• Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233
• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Saint Anthony Medical Center

  dba OSF Saint Anthony Medical Center

  • Hematology & Oncology Physician
  • Rockford, IL
  • NPI 1942248802
  Medicare reassignment Care Compare group NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Saint Anthony Medical Center

  dba OSF Saint Anthony Medical Center

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1790739977
  NPD (past)

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

• Saint Anthony Medical Center

  dba Saint Anthony Med. Ctr for Home Care

  • Home Health Agency
  • Loves Park, IL
  • NPI 1023051992
  Care Compare affiliation
• Saint Anthony Medical Center

  dba OSF Saint Anthony Medical Center

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1790739977
  Care Compare affiliation

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1407039167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8870 POLARIS DR",
            "city": "MACHESNEY PARK",
            "state": "IL",
            "postal_code": "611152258",
            "telephone_number": "815-877-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611145632",
            "telephone_number": "815-636-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHELE",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209.006878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenifer E. Johnson
• Justin William Johnson, O.D.
• Kai Johnson, LCPC
• Lisa M Johnson, M.A. CCC/SLP/L
• Megan Johnson, LCPC
• Morgan Johnson
• Nadene Johnson, L.M.T., M.M.P.
• Nadia Johnson
• Rachel Marie Johnson, LCPC
• Renee M. Johnson

• Adult Health Nurse Practitioner in Rockford, IL
• Providers in Rockford, IL by specialty
• Adult Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.