Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

JESSICA L JOHNSON
NPI 1174449128
Nurse Practitioner in Rolla, MO

Q: What is Jessica Johnson's NPI number?

The NPI number for Jessica Johnson is 1174449128. It was assigned to this individual provider in the NPPES registry on June 25, 2026.

Q: What is Jessica Johnson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jessica Johnson was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 30 days 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.

Active since June 25, 2026PECOS Enrolled

603 S BISHOP AVE, ROLLA, MO 65401(573) 426-4411(573) 426-4403 Get Directions Write a Review

NPPES record added: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Jessica L Johnson NPPES

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

JESSICA L JOHNSON (NPI 1174449128) is an individual nurse practitioner in Rolla, Missouri, licensed in Missouri (2026028820) and active in the NPI registry since June 2026. She is enrolled in Medicare PECOS and maintains a secondary practice location in Waynesville.

NPPES Registry Identity

NPI1174449128

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameJESSICA L JOHNSON

Location Address603 S BISHOP AVERolla, MO 65401-4320

Mailing Address1050 W 10th StRolla, MO 65401-2905 · (573) 364-9000 · Fax (573) 426-2108

Phone(573) 426-4411

Fax(573) 426-4403

Sole ProprietorNo

Enumeration DateJune 25, 2026

Last NPPES UpdateJuly 13, 2026

NPPES CertifiedJuly 13, 2026

✔ NPI 1174449128 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 MO · 2026028820

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.

603 S BISHOP AVE, Rolla, MO 65401

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Secondary Practice Location 1

Location 11000 Gw LnWaynesville, MO 65583-2339 · Phone (573) 842-4116 · Fax (573) 433-2008

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jessica L Johnson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 65401 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

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$93.24 typical visit price

range $16.30 – $131.05

Typical copayment $23.31 (range $4.07 – $32.76)

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 9

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

MR. RAYMOND E. BRUNO FNP

Nurse Practitioner (Family)