DR. GBEMISOLA OLUWAKEMI JOHNSON MD
NPI 1003556903
Family Medicine in Bolivar, MO

Active since March 30, 2022PECOS EnrolledAccepts Medicare Assignment
3817 S. SPRINGFIELD AVENUE, BOLIVAR, MO 6561, SUITE 140, BOLIVAR, MO 65613(417) 422-4769 Get Directions Write a Review

NPPES record last updated: October 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 11, 2025, Jun 30, 2025 (2 updates tracked since 2025).

About Dr. Gbemisola Oluwakemi Johnson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GBEMISOLA OLUWAKEMI JOHNSON MD (NPI 1003556903) is an individual family medicine provider in Bolivar, Missouri, licensed in Missouri (2025046442) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS, is affiliated with Mercy Hospital Springfield, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1003556903
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. GBEMISOLA OLUWAKEMI JOHNSONCredential: MD
Location Address3817 S. SPRINGFIELD AVENUE, BOLIVAR, MO 6561, SUITE 140Bolivar, MO 65613
Mailing Address10901 Brighton Bay Blvd Ne Apt 10209St Petersburg, FL 33716-3459 · (757) 714-2331 · Fax (727) 341-4886
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMarch 30, 2022
Last NPPES UpdateOctober 24, 20252 updates tracked since enumeration
NPPES CertifiedOctober 24, 2025
NPI 1003556903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in MO · 2025046442
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3817 S. SPRINGFIELD AVENUE, BOLIVAR, MO 6561, Bolivar, MO 65613

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Gbemisola Oluwakemi Johnson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3678947132
PECOS Enrollment IDI20251120003801
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mercy Hospital Springfield

Acute Care Hospitals · Springfield, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260065
Location1235 E CherokeeSpringfield, MO 65804 · Greene County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65613 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$93.24 typical visit price
range $16.30 – $131.05
Typical copayment $23.31 (range $4.07 – $32.76)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gbemisola Johnson's NPI number?

The NPI number for Gbemisola Johnson is 1003556903. It was assigned to this individual provider in the NPPES registry on March 30, 2022.

Where is Gbemisola Johnson located?

Gbemisola Johnson practices at 3817 S. Springfield Avenue, Bolivar, Mo 6561 Suite 140, Bolivar, MO 65613. The listed phone number is (417) 422-4769.

What is Gbemisola Johnson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Gbemisola Johnson enrolled in Medicare?

Yes. Gbemisola Johnson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Gbemisola Johnson affiliated with any hospitals?

According to CMS data, Gbemisola Johnson is affiliated with Mercy Hospital Springfield.

When was this NPI record last updated?

The NPPES record for Gbemisola Johnson was last updated on October 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.