Heidi Johnson, REGISTERED NURSE

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

041414240 Issued in IL

Practice address

7717 N Orange Prairie Rd
Peoria, IL 61615-9323

Phone

(309) 589-6800

NPI assigned

Feb 15, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Danville Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Peoria, IL
  • NPI 1336197284
  NPD (past)

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

{
    "created_epoch": "1518652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518652800000",
    "number": "1861992851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 N BROAD ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012724",
            "telephone_number": "360-865-1459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7717 N ORANGE PRAIRIE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616159323",
            "telephone_number": "309-589-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HEIDI",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-15",
        "last_updated": "2018-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "IL",
            "license": "041414240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS DEPARTMENT OF FINANCIAL AND  PROFESSIONAL REGULATION",
            "identifier": "041414240",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Kenneth Johnson, M.D.
• Daniel E Johnson, DC
• Gina Johnson, LCPC
• Gregory L Johnson, M.D.
• Hannah Johnson
• Jennifer Rebecca Johnson, LCSW
• Justin R Johnson, M.D.
• Karly L Johnson, MSW
• Katelyn M Johnson, APN, CNP
• Katherine Johnson, MSW

• Psychiatric/Mental Health Registered Nurse in Peoria, IL
• Providers in Peoria, IL by specialty
• Psychiatric/Mental Health Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2018; 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.