Individual provider Active NPI

Kerianne Evans Johnson, APN CNP

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1740333483
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209005205 Issued in IL
Practice address
18 S Michigan Ave
Chicago, IL 60603-3200
Phone
(312) 592-6800
Fax
(312) 592-6801
NPI assigned
Jan 18, 2007
Last updated
Dec 7, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

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 209005205 IL Primary

Addresses

Primary practice location

18 S Michigan Ave
Chicago, IL 60603-3200

Mailing address

1000 E Washington
Springfield, IL 62703
Phone (217) 544-2744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209005205ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of Illinois PastSince Oct 23, 2022 Accepting new patients
Planned Parenthood of Illinois Past Accepting new patients
Planned Parenthood of Illinois Past Accepting new patients
Planned Parenthood of Illinois Past Accepting new patients
Planned Parenthood of Illinois PastSince Oct 23, 2022 Accepting new patients
Planned Parenthood of Illinois PastSince Oct 23, 2022 Accepting new patients
Planned Parenthood Springfield Area Past Accepting new patients
Planned Parenthood of Illinois Past Accepting new patients
Planned Parenthood of Illinois Past Accepting new patients
Planned Parenthood of Illinois Past Accepting new patients
Planned Parenthood of Illinois Past Accepting new patients
Planned Parenthood of Illinois PastSince Oct 23, 2022 Accepting new patients

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1740333483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E WASHINGTON",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62703",
            "telephone_number": "217-544-2744",
            "fax_number": "217-544-2746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606033200",
            "telephone_number": "312-592-6800",
            "fax_number": "312-592-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KERIANNE",
        "middle_name": "EVANS",
        "name_prefix": "Ms.",
        "credential": "APN CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209005205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.