Individual provider Active NPI

Samantha Johnson, APN

  • Nurse Practitioner
  • Evanston, IL
National Provider Identifier
1689926784
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209-009758 Issued in IL
Practice address
2650 Ridge Ave
Evanston, IL 60201-1700
Phone
(847) 570-2040
NPI assigned
Oct 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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 209-009758 IL Primary
Family Nurse Practitioner 363LF0000X 209-009758 IL

Addresses

Primary practice location

2650 Ridge Ave
Evanston, IL 60201-1700

Mailing address

2650 Ridge Ave
Evanston, IL 60201-1700
Phone (847) 570-2040

Other practice location 1

2285 Sequoia Dr
Aurora, IL 60506-6209
Phone (630) 859-6800

Other practice location 2

801 S Washington St
Naperville, IL 60540-7430
Phone (847) 738-6069

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sjohnson205757@direct.myadvocateaurora.org
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20121205000475 IL Practitioner - Nurse Practitioner 1557513157 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-009758ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Hospital CurrentSince Feb 1, 2023 Accepting new patients
Elmhurst Memorial Healthcare CurrentSince Sep 19, 2023 Accepting new patients
Edward Health Ventures Nurse Practitioner CurrentSince Aug 17, 2015 Accepting new patients
Elmhurst Memorial Hospital CurrentSince Feb 1, 2023 Accepting new patients
Endeavor Health Medical Group CurrentSince Jan 9, 2024 Accepting new patients
Edward Hospital CurrentSince Feb 1, 2023 Accepting new patients
Edward Health Ventures CurrentSince Aug 17, 2015 Accepting new patients
Elmhurst Memorial Healthcare CurrentSince Sep 19, 2023 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients
Wyse Eyecare SC Past Accepting new patients

Locations

303 W Lake St
Ste 301
Addison, IL 60101
Phone (331) 221-1650

9532 Eagle Way
Chicago, IL 60678

172 E Schiller St
Elmhurst, IL 60126
Phone (331) 221-6377

420 W Butterfield Rd
Elmhurst, IL 60126
Phone (630) 832-2300

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

801 S Washington St
Naperville, IL 60540
Phone (312) 355-0450

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

1136 N Mill St
Naperville, IL 60563
Phone (630) 355-3300

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

Interoperability endpoints

  • Direct secure messaging: sjohnson49494@direct.edward.org
  • Direct secure messaging: sjohnson205757@direct.myadvocateaurora.org
  • FHIR API: https://fhirprd.edward.org/fhirprd/api/FHIR/R4/

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1689926784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2285 Sequoia Dr",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "IL",
            "postal_code": "605066209",
            "country_code": "US",
            "telephone_number": "630-859-6800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 S Washington St",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605407430",
            "country_code": "US",
            "telephone_number": "847-738-6069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SAMANTHA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-12",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-009758",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-009758",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjohnson205757@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "2285 Sequoia Dr",
            "city": "Aurora",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605066209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2285 Sequoia Dr",
            "city": "Aurora",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605066209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.