Active NPI
Kelley Erin Johnson, PNP
- Pediatric Nurse Practitioner
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 2012041691
- Practice address
- 1 Childrens PL
Div Ped Emergency Med
Saint Louis, MO 63110-1002 - Phone
- (314) 454-6000
- Fax
- (314) 747-3338
- NPI assigned
- Feb 15, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 2012041691 | MO | Primary |
Addresses
Primary practice location
1 Childrens PL
Div Ped Emergency Med
Saint Louis, MO 63110-1002
Mailing address
PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 454-6000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner, Master of Arts, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006006547 | MO | MD | Pediatric Nurse Practitioner |
| 2012041691 | MO | MD | Child & Family Psychiatric/Mental Health Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Fernando Perez Magnelli LLC | Current | Accepting new patients | |
| Mercy Clinic East Communities | Current | Accepting new patients | |
| SSM Medical Group, Inc. | Current | Accepting new patients | |
| Sinapsis Psychiatry LLC | Current | Accepting new patients | |
| Psychological & Behavioral Consultants, LLC | Current | Accepting new patients |
Locations
300 Medical Plz
Ste 310
Lake St Louis, MO 63367
Phone (314) 291-6556
300 Winding Woods Dr
O Fallon, MO 63366
Phone (636) 240-7381
2223 Technology Dr
Ste 10
O Fallon, MO 63368
Phone (636) 240-9896
300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211
621 S New Ballas Rd
Ste 693A
Saint Louis, MO 63141
Phone (314) 251-6898
621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192
1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115
4525 Mid Rivers Mall Dr
Ste 10
Saint Peters, MO 63376
Phone (314) 251-5550
255 Spencer Rd
Ste 201
Saint Peters, MO 63376
Phone (636) 929-2550
500 Medical Dr
Wentzville, MO 63385
Phone (636) 327-1000
207 Creekside Office Dr
Wentzville, MO 63385
Phone (636) 332-3381
1502 W Meyer Rd
Wentzville, MO 63385
Phone (636) 698-6200
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1851335228
-
- Multi-Specialty Clinic/Center
- Fenton, MO
- NPI 1700966207
-
- Psychiatry Physician
- Wentzville, MO
- NPI 1427364991
-
- Psychiatry Physician
- Wentzville, MO
- NPI 1275233231
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786406400000",
"number": "1942540745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7412011",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606742011",
"telephone_number": "314-454-6000",
"fax_number": "314-747-3338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CHILDRENS PL",
"address_2": "DIV PED EMERGENCY MED",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101002",
"telephone_number": "314-454-6000",
"fax_number": "314-747-3338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KELLEY",
"middle_name": "ERIN",
"name_prefix": "Ms.",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-15",
"last_updated": "2026-08-11",
"certification_date": "2022-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MO",
"license": "2012041691",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"affiliationName": "Washington University",
"address_1": "1 Childrens Pl",
"address_2": "Div Ped Emergency Med",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631101002",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.