Individual provider Active NPI

Maggie Johnson

  • Family Nurse Practitioner
  • Galesburg, IL
National Provider Identifier
1407304397
Registry record updated Jan 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209014744 Issued in IL
Practice address
3333 N Seminary St
Galesburg, IL 61401-1251
Phone
(309) 344-3161
Fax
(309) 344-9404
NPI assigned
Sep 20, 2016
Last updated
Jan 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209014744 IL
Family Nurse Practitioner 363LF0000X 209014744 IL Primary

Addresses

Primary practice location

3333 N Seminary St
Galesburg, IL 61401-1251

Mailing address

3333 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-3161

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161215001332 IL Practitioner - Nurse Practitioner 2567742240 Reassigns benefits to 7 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209014744ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Medical Group CurrentSince Jan 1, 2026 Accepting new patients
Methodist Medical Center of Illinois Nurse Practitioner CurrentSince Dec 1, 2024 Accepting new patients
Path Lab Diagnostic Services, LLC Current Accepting new patients
Methodist Medical Center of Illinois CurrentSince Dec 1, 2024 Accepting new patients
St Mary Medical Center CurrentSince Feb 7, 2023 Accepting new patients
Epss LLC - Central Series CurrentSince Nov 26, 2023 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Epss Peoria LLC CurrentSince Mar 9, 2024 Accepting new patients
Osf Multi-Specialty Group CurrentSince Oct 7, 2017 Accepting new patients
St Mary Medical Center CurrentSince Feb 7, 2023 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Methodist Medical Center of Illinois Past Accepting new patients
St Mary Medical Center Nurse Practitioner Past Accepting new patients

Locations

3333 N Seminary St
Galesburg, IL 61401
Phone (309) 344-3161

695 N Kellogg St
Galesburg, IL 61401
Phone (309) 343-8131

525 E Grant St
Macomb, IL 61455
Phone (309) 836-1611

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 680-2402

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

5409 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-1000

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735689600000",
    "number": "1407304397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011251",
            "telephone_number": "309-344-3161",
            "fax_number": "309-344-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011251",
            "telephone_number": "309-344-3161",
            "fax_number": "309-344-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MAGGIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-20",
        "last_updated": "2025-01-01",
        "certification_date": "2025-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209014744",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

Verify at the official NPI Registry.