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NICHOLAS SAMUEL JOHNSON FNP
NPI 1164309985
Family Medicine in O Fallon, MO

Active since August 21, 2025PECOS Enrolled
2223 TECHNOLOGY DR, O FALLON, MO 63368(636) 561-5999 Get Directions Write a Review

NPPES record last updated: August 21, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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 and is a graduate of Other (2025).

NPPES Registry Identity

NPI1164309985
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameNICHOLAS SAMUEL JOHNSONCredential: FNP
Location Address2223 TECHNOLOGY DRO Fallon, MO 63368-7272
Mailing Address2223 Technology DrO Fallon, MO 63368-7272 · (636) 561-5999
Phone(636) 561-5999
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateAugust 21, 2025
NPPES CertifiedAugust 21, 2025
✔ NPI 1164309985 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 · 2019006383
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.
2223 TECHNOLOGY DR, O Fallon, MO 63368
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicholas Samuel Johnson Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9335603851
PECOS Enrollment IDI20260715001346
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 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.

New Patient
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
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.

DR. ALISON JULIETE BALL D.O.
Family Medicine
2223 TECHNOLOGY DR, SUITE 40
O FALLON, MO 63368
St. Charles County (636) 755-4400

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 enrollment system.

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 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.