DR. GBEMISOLA OLUWAKEMI JOHNSON MD
NPI 1003556903
Family Medicine in Bolivar, MO
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
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignment
Medicare enrollment records show Gbemisola Johnson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Buffalo, MO 65622
- Reassigned Medicare billing, Missouri enrollment
- Also billed through NPI 1245277631 (Missouri)
- 1,487 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, MOPhysician 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.
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.
Which organization bills Medicare for Gbemisola Johnson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Gbemisola Johnson reassigns Medicare benefits to Mercy Clinic Springfield Communities (Buffalo, MO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gbemisola Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Gbemisola Johnson accept?
Health plans from Anthem Blue Cross and Blue Shield and UnitedHealthcare list Gbemisola Johnson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
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 12 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.
# Dr. Gbemisola Oluwakemi Johnson, MD · NPI 1003556903
Family Medicine physician in Bolivar, Missouri. Individual provider, active in the CMS NPPES registry since March 30, 2022.
## Identity
- **NPI:** 1003556903 (Entity type: Individual)
- **Enumerated:** March 30, 2022
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 2025046442 (Missouri)
- **Sole proprietor:** No
## Practice location
- **Address:** 3817 S. SPRINGFIELD AVENUE, BOLIVAR, MO 6561, SUITE 140, Bolivar, MO 65613
- **Phone:** (417) 422-4769
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Mercy Clinic Springfield Communities (NPI 1629103502, Buffalo, MO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** October 24, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1003556903) · Data from the CMS NPPES public registry.