NICHOLAS SAMUEL JOHNSON FNP
NPI 1164309985
Family Medicine in O Fallon, MO
About Nicholas Samuel Johnson Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NICHOLAS SAMUEL JOHNSON FNP (NPI 1164309985) is an individual family medicine provider in O Fallon, Missouri, licensed in Missouri (2019006383) and active in the NPI registry since August 2025. He is enrolled in Medicare PECOS, is affiliated with Mercy Hospital St Louis, and is a graduate of Other (2025).
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
Nicholas Samuel Johnson Fnp 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 Nicholas Johnson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Ballwin, MO 63011
- Reassigned Medicare billing, Missouri enrollment
- Also billed through NPI 1164857397 (Missouri)
- 744 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 St Louis
Acute Care Hospitals · Saint Louis, MOPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 63368 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Nicholas Johnson's NPI number?
The NPI number for Nicholas Johnson is 1164309985. It was assigned to this individual provider in the NPPES registry on August 21, 2025.
Where is Nicholas Johnson located?
Nicholas Johnson practices at 2223 Technology Dr, O Fallon, MO 63368. The listed phone number is (636) 561-5999.
What is Nicholas Johnson's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Nicholas Johnson enrolled in Medicare?
Yes. Nicholas 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 Nicholas Johnson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nicholas Johnson reassigns Medicare benefits to Mercy Clinic East Communities (Ballwin, 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 Nicholas Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Nicholas Johnson accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter of Oklahoma and Ambetter of Tennessee and 3 other insurers list Nicholas 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 Nicholas Johnson affiliated with any hospitals?
According to CMS data, Nicholas Johnson is affiliated with Mercy Hospital St Louis.
When was this NPI record last updated?
The NPPES record for Nicholas Johnson was last updated on August 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Nicholas Samuel Johnson, FNP · NPI 1164309985
Family Medicine physician in O Fallon, Missouri. Individual provider, active in the CMS NPPES registry since August 21, 2025.
## Identity
- **NPI:** 1164309985 (Entity type: Individual)
- **Enumerated:** August 21, 2025
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 2019006383 (Missouri)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2223 TECHNOLOGY DR, O Fallon, MO 63368-7272
- **Phone:** (636) 561-5999
## 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 East Communities (NPI 1700370061, Ballwin, MO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** August 21, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1164309985) · Data from the CMS NPPES public registry.