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MR. DERICK JOHNSON APRN
NPI 1154903920
Nurse Practitioner - Psychiatric/Mental Health in Chicago, IL

Active since April 22, 2021PECOS Enrolled
8543 S STONY ISLAND AVE STE 3, CHICAGO, IL 60617(312) 380-9808 Get Directions Write a Review

NPPES record last updated: May 5, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 5, 2026, Apr 22, 2021 (2 updates tracked since 2021).

About Mr. Derick Johnson Aprn NPPES

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

MR. DERICK JOHNSON APRN (NPI 1154903920) is an individual psychiatric/mental health provider in Chicago, Illinois, licensed in Illinois (209.022844) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS, maintains a secondary practice location in Chicago, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1154903920
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameMR. DERICK JOHNSONCredential: APRN
Location Address8543 S STONY ISLAND AVE STE 3Chicago, IL 60617-2249
Mailing Address11713 S Maplewood AveChicago, IL 60655-1524 · (312) 380-9808
Phone(312) 380-9808
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateApril 22, 2021
Last NPPES UpdateMay 5, 20262 updates tracked since enumeration
NPPES CertifiedMay 5, 2026
✔ NPI 1154903920 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in IL · 209.022844
Also ListedClinical Nurse Specialist · Psychiatric/Mental Health, AdultTaxonomy 364SP0809X · License 286201 (MT)
8543 S STONY ISLAND AVE STE 3, Chicago, IL 60617
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Secondary Practice Location 1

Location 19900 S Perry AveChicago, IL 60628-1348 · Phone (312) 545-3187

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Derick Johnson Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8527469030
PECOS Enrollment IDI20210622000906
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60617 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
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.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RESILIENT MENTAL HEALTH & WELLNESS PLLC
Nurse Practitioner (Psychiatric/Mental Health)
8543 S STONY ISLAND AVE STE 3
CHICAGO, IL 60617
Cook County (312) 380-9808

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 Derick Johnson's NPI number?

The NPI number for Derick Johnson is 1154903920. It was assigned to this individual provider in the NPPES registry on April 22, 2021.

Where is Derick Johnson located?

Derick Johnson practices at 8543 S Stony Island Ave Ste 3, Chicago, IL 60617. The listed phone number is (312) 380-9808.

What is Derick Johnson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Derick Johnson enrolled in Medicare?

Yes. Derick Johnson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Derick Johnson was last updated on May 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.