Melanie Elizabeth Johnson, DNP, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209023806 Issued in IL

Practice address

5023 N Illinois St
Fairview Heights, IL 62208-3453

Phone

(618) 531-9682

Fax

(800) 516-2392

NPI assigned

Oct 27, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1952065880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5023 N ILLINOIS ST",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622083453",
            "telephone_number": "618-239-0678",
            "fax_number": "800-516-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5023 N ILLINOIS ST",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622083453",
            "telephone_number": "618-531-9682",
            "fax_number": "800-516-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MELANIE",
        "middle_name": "ELIZABETH",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209023806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Rottschalk, DMD, PC
• Arielle Nicole Johnson
• Katherine Johnson I, PTA
• Kaylin Johnson
• Kourtney Johnson, RBT
• Thomas John Johnson, O.D.
• Gloria Jones
• Jennifer R Jones, OTR/L, CHT
• Talia Jones
• Susan L Journagan, M.D.

• Family Nurse Practitioner in Fairview Heights, IL
• Providers in Fairview Heights, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.

Verify at the official NPI Registry.