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KATELYN M JOHNSON APN, CNP
NPI 1174093009
Nurse Practitioner in Peoria, IL

Active since December 04, 2018PECOS EnrolledAccepts Medicare Assignment
200 E PENNSYLVANIA AVE, PEORIA, IL 61603(309) 624-4000(309) 624-4010 Get Directions Write a Review

NPPES record last updated: December 4, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Katelyn M Johnson Apn, Cnp NPPES

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

KATELYN M JOHNSON APN, CNP (NPI 1174093009) is an individual nurse practitioner in Peoria, Illinois, licensed in Illinois (209018151) and active in the NPI registry since December 2018. She is enrolled in Medicare PECOS, is affiliated with St Mary Medical Center, and is a graduate of University Of Iowa, Rj & L Carver College Of Medicine (2018).

NPPES Registry Identity

NPI1174093009
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameKATELYN M JOHNSONCredential: APN, CNP
Location Address200 E PENNSYLVANIA AVEPeoria, IL 61603-3089
Mailing Address200 E Pennsylvania AvePeoria, IL 61603-3089 · (309) 624-4000 · Fax (309) 624-4010
Phone(309) 624-4000
Fax(309) 624-4010
Sole ProprietorNo
Medical School CMSUniversity Of Iowa, Rj & L Carver College Of MedicineGraduated 2018
Enumeration DateDecember 4, 2018
✔ NPI 1174093009 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in IL · 209018151
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
200 E PENNSYLVANIA AVE, Peoria, IL 61603
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

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

Katelyn M Johnson Apn, Cnp 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 ID1951646454
PECOS Enrollment IDI20190102000957
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.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
102 services66 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
59 services47 patients
Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212
This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.
29 services20 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
28 services23 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
24 services18 patients
Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212
This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.
23 services18 patients

Hospital Affiliations CMS Care Compare 5

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

St Mary Medical Center

Acute Care Hospitals · Galesburg, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140064
Location3333 North SeminaryGalesburg, IL 61401 · Knox County
Emergency services Birthing friendly

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140067
Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County
Emergency services Birthing friendly

Osf Saint Elizabeth Mdl Ctr

Acute Care Hospitals · Ottawa, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140110
Location1100 E Norris DriveOttawa, IL 61350 · La Salle County
Emergency services Birthing friendly

Methodist Medical Center Of Illinois

Acute Care Hospitals · Peoria, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140209
Location221 N E Glen Oak AvePeoria, IL 61636 · Peoria County
Emergency services Birthing friendly

Osf Saint Luke Medical Center

Critical Access Hospitals · Kewanee, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141325
Location1051 West South StreetKewanee, IL 61443 · Henry County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61603 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
2 suppliers12 claims12 services$45.61 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
2 suppliers13 claims13 services$118.04 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
2 suppliers11 claims24 services$44.04 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
2 suppliers14 claims62 services$2.82 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers19 claims19 services$52.35 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

DR. DOUGLAS JUVINALL MD
Psychiatry & Neurology (Neurology)
200 E PENNSYLVANIA AVE
PEORIA, IL 61603
Peoria County (309) 624-4000
DR. CAROLINE MARIE RAYBURN AUD
Audiologist
200 E PENNSYLVANIA AVE
PEORIA, IL 61603
Peoria County (309) 624-4000
DR. JOHN W HSU MD
Transplant Surgery
200 E PENNSYLVANIA AVE, SUITE 212
PEORIA, IL 61603
Peoria County (309) 676-8123
DEAN A GRAVLIN M.D.
Internal Medicine
200 E PENNSYLVANIA AVE, STE 105
PEORIA, IL 61603
Peoria County (309) 655-7888
FREDERICK HORVATH MD
Internal Medicine (Nephrology)
200 E PENNSYLVANIA AVE, SUITE 212
PEORIA, IL 61603
Peoria County (309) 676-8123
MRS. EVANNE M IHNKEN PA-C
Physician Assistant
200 E PENNSYLVANIA AVE
PEORIA, IL 61603
Peoria County (309) 624-4000
KAVYA MORAVINENI MD
Psychiatry & Neurology (Neurology)
200 E PENNSYLVANIA AVE
PEORIA, IL 61603
Peoria County (309) 624-4000
LOAN T NGUYEN APN, CNP
Nurse Practitioner
200 E PENNSYLVANIA AVE
PEORIA, IL 61603
Peoria County (309) 624-4000

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 Katelyn Johnson's NPI number?

The NPI number for Katelyn Johnson is 1174093009. It was assigned to this individual provider in the NPPES registry on December 4, 2018.

Where is Katelyn Johnson located?

Katelyn Johnson practices at 200 E Pennsylvania Ave, Peoria, IL 61603. The listed phone number is (309) 624-4000.

What is Katelyn Johnson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Katelyn Johnson enrolled in Medicare?

Yes. Katelyn 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.

What insurance does Katelyn Johnson accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Katelyn 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 Katelyn Johnson affiliated with any hospitals?

According to CMS data, Katelyn Johnson is affiliated with St Mary Medical Center, Saint Francis Medical Center, Osf Saint Elizabeth Mdl Ctr, Methodist Medical Center Of Illinois and Osf Saint Luke Medical Center.

When was this NPI record last updated?

The NPPES record for Katelyn Johnson was last updated on December 4, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.