Individual provider Active NPI

Sonda Rena Johnson, NP

  • Nurse Practitioner
  • Belleville, IL
National Provider Identifier
1679003628
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.015355 Issued in IL
Practice address
3909A N Belt W
Belleville, IL 62226-5607
Phone
(618) 746-1142
Fax
(618) 737-0080
NPI assigned
Jun 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.015355 IL Primary

Addresses

Primary practice location

3909A N Belt W
Belleville, IL 62226-5607

Mailing address

3909A N Belt W
Belleville, IL 62226-5607
Phone (618) 746-1142

Other practice location 1

56 S 65th St Ste 6
Belleville, IL 62223-2945
Phone (618) 746-1142

Other practice location 2

159 E McArthur Dr
Bethalto, IL 62010-1918
Phone (618) 258-7504

Other practice location 3

108 W US Highway 40
Troy, IL 62294-1836
Phone (618) 667-1800

Other practice location 4

17 Ginger Creek Mdws
Glen Carbon, IL 62034-3508
Phone (618) 656-9777

Other practice location 5

1103 Belt Line Rd
Collinsville, IL 62234-4368
Phone (618) 344-2273

Other practice location 6

6800 State Route 162
Maryville, IL 62062-8500
Phone (618) 288-5711

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
I20170802001337 IL Practitioner - Nurse Practitioner 1355612888 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3909 N Belt W
Belleville, IL 62226-5607
Phone (618) 746-1142

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.015355ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Jul 14, 2023 Accepting new patients
Renees Solution Services CurrentSince Jul 1, 2022 Accepting new patients
Ahs Il Medical Group LLC CurrentSince Feb 5, 2024 Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

3909 N Belt W
Belleville, IL 62226
Phone (618) 746-1142

3909 N Belt W
#A
Belleville, IL 62226
Phone (618) 236-0900

56 S 65th St
Ste 6
Belleville, IL 62223
Phone (618) 746-1142

1000 Eleven S
Ste 1A
Columbia, IL 62236
Phone (618) 281-8400

4273 S State Route 159
Glen Carbon, IL 62034
Phone (618) 288-2297

2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Interoperability endpoints

  • Direct secure messaging: sjohn594@yourcarecommunity.org

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 1

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": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1679003628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909A N BELT W",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265607",
            "telephone_number": "618-746-1142",
            "fax_number": "618-737-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909A N BELT W",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265607",
            "telephone_number": "618-746-1142",
            "fax_number": "618-737-0080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "56 S 65th St Ste 6",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622232945",
            "country_code": "US",
            "telephone_number": "618-746-1142",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "159 E McArthur Dr",
            "address_purpose": "LOCATION",
            "city": "Bethalto",
            "state": "IL",
            "postal_code": "620101918",
            "country_code": "US",
            "telephone_number": "618-258-7504",
            "fax_number": "618-258-7542",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "108 W US Highway 40",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "IL",
            "postal_code": "622941836",
            "country_code": "US",
            "telephone_number": "618-667-1800",
            "fax_number": "618-667-1802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17 Ginger Creek Mdws",
            "address_purpose": "LOCATION",
            "city": "Glen Carbon",
            "state": "IL",
            "postal_code": "620343508",
            "country_code": "US",
            "telephone_number": "618-656-9777",
            "fax_number": "618-656-1249",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1103 Belt Line Rd",
            "address_purpose": "LOCATION",
            "city": "Collinsville",
            "state": "IL",
            "postal_code": "622344368",
            "country_code": "US",
            "telephone_number": "618-344-2273",
            "fax_number": "618-344-3034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6800 State Route 162",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "IL",
            "postal_code": "620628500",
            "country_code": "US",
            "telephone_number": "618-288-5711",
            "fax_number": "618-288-4088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SONDA",
        "middle_name": "RENA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.015355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.