Anitra Johnson, RN

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

041473737 Issued in IL

Practice address

4230 11TH St
Rock Island, IL 61201-6746

Phone

(309) 788-4571

Fax

(309) 788-7132

NPI assigned

Aug 18, 2025

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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.

• The Robert Young Center for Community Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rock Island, IL
  • NPI 1609360163
  NPD (past)
• Center for Alchol & Drug Services, Inc.

  • Substance Abuse Rehabilitation Facility
  • Davenport, IA
  • NPI 1245236942
  NPD (past)

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1982581534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 ELMORE AVE APT K7",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073592",
            "telephone_number": "563-210-6871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 11TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612016746",
            "telephone_number": "309-788-4571",
            "fax_number": "309-788-7132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANITRA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "041473737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffery M Jauron, DO
• Claire E Jeffers
• Jeffrey F Fullenkamp DO LTD
• Joanne a Michaelson MD
• John C Hendricks MD SC
• Dana Ellyn Johnson, DPT
• Quinn Cameron Johnson, RN
• Margaret Jones-Meersman, DPT
• Brandon Jones
• Bruce Jones, MD

• Addiction (Substance Use Disorder) Registered Nurse in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Addiction (Substance Use Disorder) Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.